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Bourgognon F, Bechet D, Huin-Schohn C, Strelow A, Demarche L, Guillou M, Adam V, Fall E, Omorou AY. A mixed method feasibility and acceptability study of a flexible intervention based on acceptance and commitment therapy for patients with cancer. Front Psychol 2024; 15:1409308. [PMID: 39021646 PMCID: PMC11252038 DOI: 10.3389/fpsyg.2024.1409308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Propose This study aimed to propose an innovative, open, and circular program that combines acceptance and commitment therapy (ACT) and mindfulness practices. We assessed its feasibility, acceptability, and first signs of its effect on psychological wellbeing in cancer support treatment. Methods A single-center, single-arm, uncontrolled study was performed. Forty adult patients with non-metastatic prostate or breast cancer, newly diagnosed or undergoing treatment (chemotherapy, radiotherapy, hormone therapy), were recruited. Three cycles of three MAEva program sessions (MAEva: Mindfulness meditation, Acceptance, and Commitment to values program) over nine consecutive weeks were proposed. During the total of 12 weeks of follow-up, after attending the first session, patients were free to attend subsequent sessions. Results Adherence to the study was high, with participation in an average of 6.8 out of nine sessions. A total of eight patients attended all sessions over the three cycles, and 90% participated in at least one cycle. Furthermore, attendance was associated with a statistically significant improvement in Quality of Life (QoL). Each additional session was associated with a mean increase in overall QoL score of more than one point (β = 1.09 [0.13; 2.04], p = 0.02). The fatigue dimensions decreased with session attendance: physical (β = -2.24 [-3.63; -0.85]), emotional (β = -2.60 [-4.11; -1.09]), and interference with daily life (β = -2.33 [-3.95; -0.72]). The qualitative section demonstrated that patients learned skills and shared their ability to "let go". Patients rated the degree of importance of the program at 8.36/10 (SD ± 1.64). Conclusion This study highlights the feasibility and acceptability of an original program that combines ACT and mindfulness practices in cancer patients. Future studies are required to demonstrate the efficacy of the MAEVA program. The MAEva pilot study is registered with ClinicalTrials.gov under the identifier NCT04751201. Clinical trial registration https://classic.clinicaltrials.gov/ct2/show/NCT04751201, identifier [NCT04751201].
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Affiliation(s)
- François Bourgognon
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Denise Bechet
- Departement of Clinical Research, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Cécile Huin-Schohn
- Departement of Clinical Research, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | | | - Laëtitia Demarche
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Mireille Guillou
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Virginie Adam
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandæuvre-lès-Nancy, France
| | - Estelle Fall
- Université de Lorraine, Inserm, INSPIIRE, Nancy, France
| | - Abdou Yacoubou Omorou
- Université de Lorraine, Inserm, INSPIIRE, Nancy, France
- CIC-1433 Clinical Epidemiology, Nancy, France
- The French National Platform Quality of Life and Cancer, Nancy, France
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Martinez-Calderon J, Casuso-Holgado MJ, Cano-García FJ, Heredia-Rizo AM. Integrative model for self-perception of well-being in cancer. Disabil Rehabil 2024; 46:2441-2448. [PMID: 37303159 DOI: 10.1080/09638288.2023.2222645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE Continual illness uncertainty can affect how people perceive and interpret their well-being. Some cognitive and spiritual factors may be involved in the management of disruptive thoughts and emotions that can emerge during the experience of cancer. MATERIAL AND METHODS An evidence-based integrative model was developed to evaluate and show the role that mindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life play in the self-perception of well-being in individuals with cancer. This evidence-based integrative model was conducted using relevant and selected studies. RESULTS An integrative model for self-perception of well-being has been proposed. This model integrates evidence-based findings and provides clear principles for clinicians and researchers. This integrative model proposes that mindfulness, acceptance, self-efficacy perception, and uncertainty can predict how people with cancer perceive their well-being. The model also posits that meaning and purpose in life can act as mediators or moderators of this prediction. CONCLUSIONS This integrative model involves the multidimensionality of human beings and facilitates the understanding of some key factors for the design of therapeutic approaches such as Acceptance & Commitment Therapy or Meaning-Centered Psychotherapy.IMPLICATIONS FOR REHABILITATIONMindfulness, acceptance, self-efficacy, uncertainty, meaning, and purpose in life can be highly relevant for clinical oncology.An integrative model is proposed to understand the combined influence of these factors on patients with cancer.This model may favor a better integration of well-known interventions, such as Mindfulness-based approaches, Acceptance and Commitment Therapy (ACT), and Meaning-Centered Psychotherapy (MCP).
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | | | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
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Zhao W, Chong YY, Yang S, Kuerban D, Zhang W, Wang X, Li X, Chien WT. Reliability and validity of the translated Chinese version of comprehensive assessment of acceptance and commitment therapy processes (CompACT-C) in breast cancer survivors. Heliyon 2024; 10:e25956. [PMID: 38390041 PMCID: PMC10881337 DOI: 10.1016/j.heliyon.2024.e25956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
Purpose This study aimed to translate and validate a Chinese version of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT-C), a 23-item questionnaire for measuring an individual's level of psychological flexibility among Chinese breast cancer survivors for utilisation of Acceptance and commitment therapy (ACT)-based interventions in breast cancer patients. Methods Six translators translated the original English version into Chinese according to Brislin's Translation Model. Psychometric properties tests were conducted on the CompACT-C, including internal consistency, test-retest reliability (two-week interval), face validity, content validity, convergent validity with experiential avoidance, and construct validity (confirmatory factor analysis). Results 308 Chinese breast cancer survivors with mastectomies were conveniently recruited. The translated scale showed satisfactory test-retest reliability (two-week interval, r = 0.53-0.72, p < 0.001), face validity, and content validity (CVI-Scale/CVS-Item = 1.00). According to the confirmatory factor analysis results, the final Chinese version remained the 23 items and three dimensions, with the modification of item six from the dimension of openness to experience to behavioural awareness for better model fitness [structural equation model analysis, χ2 = 559.486, df = 226, NC (χ2/df) = 2.476, RMSEA = 0.069, CFI = 0.834, TLI = 0.815, SRMR = 0.079] and satisfactory internal consistency (Cronbach's α = 0.71), convergent validity with AAQ-2 (r = -0.57, p < 0.001) in these breast cancer patients. Conclusions The Chinese version of the CompACT showed good reliability and validity among Chinese breast cancer patients. Future research is suggested to confirm its psychometric properties with diverse breast and other cancer groups.
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Affiliation(s)
- Wenqian Zhao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shan Yang
- School of Nursing, Faculty of Medicine the Xi'an Jiao Tong University, Xi'an, Shaanxi Province, China
| | - Dilihumaer Kuerban
- School of Nursing, Faculty of Medicine the Xi'an Jiao Tong University, Xi'an, Shaanxi Province, China
| | - Wei Zhang
- Breast Surgery Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Xiao Wang
- Breast Surgery Department, Shaanxi Provincial Tumor Hospital, Xi'an, Shaanxi Province, China
| | - Xiaomei Li
- School of Nursing, Faculty of Medicine the Xi'an Jiao Tong University, Xi'an, Shaanxi Province, China
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Jiang X, Sun J, Song R, Wang Y, Li J, Shi R. Acceptance and commitment therapy reduces psychological distress in patients with cancer: a systematic review and meta-analysis of randomized controlled trials. Front Psychol 2024; 14:1253266. [PMID: 38250124 PMCID: PMC10796538 DOI: 10.3389/fpsyg.2023.1253266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/16/2023] [Indexed: 01/23/2024] Open
Abstract
Objective This study aimed to systematically review and meta-analyze the clinical efficacy of acceptance and commitment therapy (ACT) in patients with cancer and psychological distress. Methods Randomized controlled trials (RCTs) from seven English electronic databases were systematically investigated from inception to 3 October 2023. A total of 16 RCTs from 6 countries with 711 participants were included in this study. Estimated pooled effect sizes (ESs) were calculated via inverse-variance random-effects or fixed-effects (I2 ≤ 50%) model and presented by standardized mean difference (SMD). Subgroup analyses were performed to reduce confounding factors and heterogeneity, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to evaluate the quality of the pooled ESs. Results The pooled ESs revealed that statistically significant improvements in anxiety [postintervention SMD = -0.41 (95% confidence interval (CI), -0.71, -0.11); p = 0.008; I2 = 65%; follow-up SMD = -0.37 (95% CI, -0.66, -0.08); p = 0.01; I2 = 29%], depression [postintervention SMD = -0.45 (95% CI, -0.63, -0.27); p < 0.001; I2 = 49%; follow-up SMD = -0.52 (95% CI, -0.77, -0.28); p < 0.001; I2 = 0%], and psychological flexibility [postintervention SMD = -0.81 (95% CI, -1.50, -0.11); p = 0.02; I2 = 84%; follow-up SMD = -0.71 (95% CI, -1.12, -0.31); p = 0.0006; I2 = 38%] in ACT-treated participants were observed compared to patients treated with control conditions. However, other outcomes, such as physical symptom alleviation, were not significantly associated. Conclusion The findings of this systematic review and meta-analysis suggest that ACT is associated with improvements in anxiety, depression, and psychological flexibility in patients with cancer. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320515.
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Affiliation(s)
- Xing Jiang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jian Sun
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ruiwen Song
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yue Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jinglian Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Rongwei Shi
- Department of Internal Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Zhang Y, Ding Y, Chen X, Li Y, Li J, Hu X. Effectiveness of acceptance and commitment therapy on psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer: A meta-analysis of randomized controlled trials. Worldviews Evid Based Nurs 2023; 20:582-592. [PMID: 37194163 DOI: 10.1111/wvn.12652] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Current studies have revealed that acceptance and commitment therapy (ACT) can alleviate the adverse effects of cancer; however, its effectiveness on the psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer remains unclear. AIMS The aims of this study were to identify the effectiveness of ACT on psychological flexibility, fatigue, sleep disturbance, and quality of life of patients with cancer, and to explore moderators. METHODS PubMed, Embase, Web of Science, CENTRAL, PsycINFO, CINAHL, CNKI, VIP, and Wanfang electronic databases were searched from inception to September 29, 2022. The Cochrane Collaboration's risk-of-bias assessment tool II and the Grading of Recommendations Assessment, Development, and Evaluation approach were used to evaluate evidence certainty. The data were analyzed using R Studio. The study protocol was registered with PROSPERO (CRD42022361185). RESULTS The study included 19 relevant studies (1643 patients) published between 2012 and 2022. The pooled results showed that ACT significantly improved psychological flexibility (mean difference [MD] = -4.22, 95% CI [-7.86, -0.58], p = .02) and quality of life (Hedges' g = 0.94, 95% CI [0.59, 1.29], Z = 5.31, p < .01) but did not significantly improve fatigue (Hedges' g = -0.03, 95% CI [-0.24, 0.18], p = .75) or sleep disturbance (Hedges' g = -0.26, 95% CI [-0.82, 0.30], p = .37) in patients with cancer. Additional analyses revealed a 3-month sustainable effect on psychological flexibility (MD = -4.36, 95% CI [-8.67, -0.05], p < .05), and moderation analysis showed that intervention duration (β = -1.39, p < .01) and age (β = 0.15, p = .04) moderated the effects of ACT on psychological flexibility and sleep disturbance, respectively. LINKING EVIDENCE TO ACTION Acceptance and commitment therapy demonstrates effectiveness for psychological flexibility and quality of life of patients with cancer, but there is a lack of evidence regarding its effects on fatigue and sleep disturbance. In clinical practice, ACT should be designed in more detail and rounded to achieve better results.
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Affiliation(s)
- Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yuxin Ding
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Abstract
Breast cancer is the most commonly diagnosed cancer in women. Associated psychological symptoms include stress, adjustment difficulties, anxiety, depression, impaired cognitive function, sleep disturbances, altered body image, sexual dysfunction, and diminished overall well-being. Distress screening and assessment identifies women who will benefit from therapeutic interventions. Addressing these symptoms improves compliance with treatment and outcomes including disease-related outcomes, psychological symptoms, and quality of life. The most effective treatments include teaching coping skills such as expressing emotion, along with other structured cognitive behavioral, interpersonal, and mindfulness approaches. Patients should be provided these psychosocial supports throughout their cancer journey.
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Affiliation(s)
- Jennifer Kim Penberthy
- Department of Psychiatry & Neurobehavioral Sciences, UVA Cancer Center, University of Virginia School of Medicine & Health System, PO Box 800623, Charlottesville, VA 22908, USA.
| | - Anne Louise Stewart
- Department of Psychiatry & Neurobehavioral Sciences, UVA Cancer Center, University of Virginia School of Medicine & Health System, PO Box 800623, Charlottesville, VA 22908, USA
| | - Caroline F Centeno
- Department of Psychiatry & Neurobehavioral Sciences, UVA Cancer Center, University of Virginia School of Medicine & Health System, PO Box 800623, Charlottesville, VA 22908, USA
| | - David R Penberthy
- Department of Radiation Oncology, Penn State Cancer Institute, Penn State Health Milton S. Hershey College of Medicine, Hershey, PA, USA
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Jones KF, Fu MR, Wood Magee L, Merlin J, Check DK, McTernan M, Bernacki R, Bulls HW. "It Is So Easy For Them to Dismiss": A Phenomenological Study of Cancer Survivors With Chronic Cancer-Related Pain. J Palliat Med 2023; 26:1090-1099. [PMID: 36944115 PMCID: PMC10440651 DOI: 10.1089/jpm.2022.0538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
Background: For many cancer survivors post-cure, chronic pain is a devastating complication of cancer treatment. The prevalence of chronic pain among cancer survivors is double that of the general population. However, little is known about the pain experience of cancer survivors who may have a different perspective than people with advanced cancer or people with noncancer pain. Objective: To understand the lived experience of chronic cancer-related pain in cancer survivors. Methods: We used a qualitative design with a descriptive phenomenological method to conduct in-depth interviews of 13 cancer survivors residing in the United States who completed curative cancer therapy, were at least three months from treatment, and experienced pain attributable to cancer. Data collection was focused on the lived experience and management of chronic cancer-related pain and a deep understanding of how the experience of chronic cancer-related pain shapes pain management choices. Results: The participants had a variety of primary cancer types and cancer pain syndromes. Three essential themes epitomized the experience of living with chronic cancer-related pain: invisible suffering at the cost of survival, an opioid paradox, and a lack of answers on what to expect and what might help. Conclusion and Implications: The results highlight an opportunity for pain self-management, education, and psychosocial interventions to optimize pain in cancer. Participants' experiences identify several opportunities to improve chronic cancer-related pain. Future efforts should prioritize access to multimodal pain treatments, high-quality communication, and expand clinicians' knowledge and skills to manage chronic pain.
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Affiliation(s)
| | - Mei R. Fu
- School of Nursing–Camden, Rutgers University, Camden, New Jersey, USA
| | - Lisa Wood Magee
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Jessica Merlin
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Devon K. Check
- Population Health Sciences, Duke Cancer Institute, Durham, North Carolina, USA
| | - Melissa McTernan
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Rachelle Bernacki
- Division of Psychosocial Oncology and Palliative Care, Dana Faber-Cancer Institute, Boston, Massachusetts, USA
| | - Hailey Waddell Bulls
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Review of psychological interventions in patients with cancer. Support Care Cancer 2023; 31:210. [PMID: 36913136 DOI: 10.1007/s00520-023-07675-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Cancer is one of the leading causes of mortality in the world and also causes morbidity and deterioration in the mental health of patients and their caregivers. The most commonly reported psychological symptoms include anxiety, depression, and the fear of recurrence. The purpose of this narrative review is to elaborate and discuss the effectiveness of the different interventions employed and their utilities in clinical practice. METHODS Scopus and PubMed databases were searched, with a timeframe from 2020 to 2022, to identify randomised controlled trials, meta-analyses, and reviews and reported using PRISMA guidelines. Articles were searched by the following keywords: "cancer, psychology, anxiety, and depression". An additional search was performed with the keywords "cancer, psychology, anxiety, depression, and [intervention name]". The most popular psychological interventions were included in these search criteria. RESULTS A total of 4829 articles were retrieved by the first preliminary search. After reducing duplicates, 2964 articles were assessed for inclusion according to eligibility criteria. After the full-text screening, 25 final articles were chosen. To systematise psychological interventions as described in the literature, the authors have divided them into 3 broad categories, each type targeting a specific domain of mental health: cognitive-behavioural, mindfulness, and relaxation. CONCLUSION The most efficient psychological therapies, as well as therapies which require more extensive research, were outlined in this review. The authors discuss the necessity of primary assessment of patients and whether they require the help of a specialist. With the limitations of the potential risk of bias, an overview of different therapies and interventions targeting various psychological symptoms is outlined.
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Neubert S, Schlecht S, Meng K, Rabe A, Jentschke E. Effects of a Video Sequence Based Intervention on Anxiety, Fatigue and Depression in Cancer Patients: Results of a Randomized Controlled Trial. Integr Cancer Ther 2023; 22:15347354231153172. [PMID: 36799503 PMCID: PMC9940180 DOI: 10.1177/15347354231153172] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Cancer patients often suffer from psychological symptoms and need psychological support. Especially during the COVID-19 pandemic, eHealth interventions might be helpful to overcome the obstacles of the pandemic. This study evaluates the effectiveness of a video sequence-based eHealth intervention on anxiety, fatigue, and depression in cancer patients. METHODS Patients (N = 157) with different tumor entities were randomly assigned to the video intervention group (IG) and the waiting control group (CG). Patients in the IG received a video intervention comprising 8 video sequences over 4 weeks. The videos included psychoeducation on distress and psychological symptoms, Acceptance and Commitment Therapy elements, and Yoga and Qigong exercises. Patients' anxiety and fear of progression (primary outcomes) and secondary outcomes were assessed before randomization (T1) and after the end of the intervention for IG or the waiting period for CG (T2) using self-reported questionnaires (GAD-7, PA-F-KF, EORTC QLQ-FA12, PHQ-8). RESULTS Patients of the IG showed no significant improvement in anxiety (GAD-7; P = .75), fear of progression (FoP-Q-SF; P = .29), fatigue (EORTC QLQ-FA12; P = .72), and depression (PHQ-8; P = .95) compared to patients in the waiting CG. However, symptoms of anxiety, fatigue, and depression decreased in both groups. Exploratory subgroup analysis regarding sex, therapy status, therapy goal, and tumor entity showed no effects. Overall, the intervention had a high level of acceptance. CONCLUSIONS The video intervention was ineffective in reducing the psychological burden compared to a waiting CG. The findings support prior observations of the value of therapeutic guidance and promoting self-management for improving patients' psychological burdens. Further studies are required to evaluate the effectiveness of psycho-oncological eHealth delivered through video sequences.
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Affiliation(s)
- Sven Neubert
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Sina Schlecht
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Karin Meng
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Antonia Rabe
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Elisabeth Jentschke
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany,Elisabeth Jentschke, University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef Schneider Str 6, Würzburg D-97080, Germany.
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Fang P, Tan L, Cui J, Yu L. Effectiveness of Acceptance and Commitment Therapy for people with advanced cancer: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2023; 79:519-538. [PMID: 36534441 DOI: 10.1111/jan.15543] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/08/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022]
Abstract
AIMS To systematically review existing evidence and assess the effectiveness of Acceptance and Commitment Therapy for people with advanced cancer. DESIGN Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES Nine databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure, VIP Database and Wanfang, were searched. The search covered the period between the inception of the selected databases and August 2022. REVIEW METHODS Two authors independently examined eligible studies and appraised the methodological quality of the included studies by applying the criteria suggested by the Cochrane Effective Practice and Organization of Care followed by data abstraction. The Template for Intervention Description and Replication (TIDieR) checklist was used to identify intervention characteristics. Meta-analysis was performed using RevMan 5.4 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. RESULTS Eight studies, involving 488 people with advanced cancer, were included. The results showed significant effects of Acceptance and Commitment Therapy on the improvement of quality of life and the alleviation of anxiety, depression, psychological distress and fatigue in people with advanced cancer. However, its effects in relieving psychological flexibility and pain were not statistically significant. The certainty of the evidence was low to moderate. CONCLUSION People with advanced cancer can benefit from Acceptance and Commitment Therapy, which is conducive to improving their health outcomes. IMPACT This review provides evidence about the effectiveness of Acceptance and Commitment Therapy in people with advanced cancer. Further well-designed studies with larger sample sizes are required. This review may help nurses and researchers to design and implement Acceptance and Commitment Therapy in clinical practice, thereby improving health outcomes in this population. PROSPERO REGISTRATION NUMBER CRD42021244568.
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Affiliation(s)
- Pei Fang
- School of Nursing, Wuhan University, Wuhan, China
| | - Lanhui Tan
- School of Nursing, Wuhan University, Wuhan, China
| | - Jiaxin Cui
- School of Nursing, Wuhan University, Wuhan, China
| | - Liping Yu
- School of Nursing, Wuhan University, Wuhan, China
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Li Z, Shang W, Wang C, Yang K, Guo J. Characteristics and trends in acceptance and commitment therapy research: A bibliometric analysis. Front Psychol 2022; 13:980848. [PMID: 36452380 PMCID: PMC9702511 DOI: 10.3389/fpsyg.2022.980848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/24/2022] [Indexed: 02/05/2024] Open
Abstract
Purpose As acceptance and commitment therapy (ACT) becomes mainstream and a growing body of literature emerges, it is critical to map the global collaborative network and a quantitative and systematic assessment of ACT, as research on this topic is still lacking. This review aims to provide a comprehensive understanding of the trajectory, key themes, and future prospects in ACT research. Methods Publications were extracted from the Web of Science Core Collection before 2022. Excel 2019, VOSviewer, and CiteSpace software were used to analyze the characteristics and trends of ACT research. Examples include publications trend analysis, authors' cooperation network analysis, keywords co-occurrence analysis, and citation burst analysis. Results A total of 799 articles in 314 journals contributed by 2,862 authors from 958 institutions in 52 countries were identified. The number of publications has increased significantly since 2015. The United States/Utah State University is the most productive country/institution; Karolinska Institute, Utah State University, and King's College of London are the most significant nodes. Twohig M.P., Hayes S.C., and Levin M.E. are the most influential authors. Keyword co-occurrence analysis found the curative mechanisms, using network technology or mobile technology as adjuvant therapy, reducing psychological diseases of cancer patients were potential trends. Conclusion This review is the first attempt of its kind to systematically examine the knowledge structure and draw an evidence map of ACT research. It deepens the understanding of existing research, gives many operable research directions and suggests to future ACT research.
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Affiliation(s)
- Zhihong Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Wenru Shang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, Gansu, China
| | - Caiyun Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Juanmei Guo
- Hospital Management Research Center, School of Management, Lanzhou University, Lanzhou, China
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The Effectiveness of Cognitive-Behavioral, Mindfulness and Acceptance and Commitment Therapies to Improving the Psychological Symptoms of Patients with Multiple Sclerosis in Iran (Systematic Review and Meta-analysis). IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2022. [DOI: 10.5812/ijpbs-127590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Context: Multiple sclerosis (MS) is a neurological disease in which the myelin lining the central nervous system is damaged and often occurs between the ages of 20 and 40. In addition to loss of motor, sensory, and cognitive function, patients with MS also experience related symptoms such as depression, anxiety, stress, fatigue, and pain. Objectives: The aim of this study was to systematically and meta-analyze the effectiveness of cognitive-behavioral, mindfulness and acceptance and commitment (CMAC) therapies to improving the psychological symptoms of patients with multiple sclerosis in Iran. Methods: The study was conducted using preferred reporting items for systematic reviews and meta-analysis. This study examined articles published from the beginning until November 20, 2021 in Persian and English on cognitive and behavioral interventions performed in Iran, in order to influence psychological symptoms for people with multiple sclerosis. Articles relevant to research were screened in external (Google Scholar, PubMed, Scopus, Science Direct, Web of Science) and internal databases (Sid, Magiran, Ganj, Irandoc, Civilica). The quality of the included RCTs was assessed using the Cochrane guideline risk of bias tool. The results were expressed in terms of mean difference (MD) and the corresponding 95% confidence interval. Data analyses were performed by RevMan5.4. Results: In the first stage of the search, 792 articles were obtained. After reviewing the titles of the articles, 701 articles were discarded due to irrelevance and duplication and 91 articles remained. Finally, 21 studies were selected by reviewing the abstracts and considering the inclusion criteria. Compared with the control group, the standardized mean difference (SMD) estimate depression was 1.60 (2.27, 0.93), for anxiety 0.49 (0.80, 0.19), for stress 0.97 (1.70, 0.23) and for fatigue 0.19 (2.75, 1.25) had a positive effect; But no significant effect on pain reduction equal to 0.49 (2.21, 1.23) was not found. Conclusions: The meta-analysis in the posttest showed that the effects of CMAC were considerable on reducing depression, anxiety, stress, and fatigue, but the effects were not notable for pain mitigation. Future high quality studies with follow-up evaluations are needed to support the effects of CMAC on reducing symptoms in people with multiple sclerosis and to evaluate the interventional features that enhance and maintain the effects.
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Rentscher KE, Carroll JE, Juckett MB, Coe CL, Broman AT, Rathouz PJ, Hematti P, Costanzo ES. Sleep Disruption, Fatigue, and Depression as Predictors of 6-Year Clinical Outcomes Following Allogeneic Hematopoietic Cell Transplantation. J Natl Cancer Inst 2021; 113:1405-1414. [PMID: 33693799 PMCID: PMC8633423 DOI: 10.1093/jnci/djab032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/04/2021] [Accepted: 03/04/2021] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Allogeneic hematopoietic cell transplantation (HCT) is a widely used treatment for hematologic cancers, with survival rates ranging from 25% to 78%. Known risk factors for chronic graft-versus-host disease (cGVHD), a serious and common long-term complication, disease relapse, and mortality following HCT have been identified, but much of the variability in HCT outcomes is unexplained. Biobehavioral symptoms including depression, sleep disruption, and fatigue are some of the most prevalent and distressing for patients; yet research on biobehavioral risk factors for HCT outcomes is limited. This study evaluated patient-reported depression, sleep disruption, and fatigue as risk factors for cGVHD, disease relapse, and mortality. METHODS Adults receiving allogeneic HCT for a hematologic malignancy (N = 241) completed self-report measures of depression symptoms, sleep quality, and fatigue (severity, interference) pre-HCT and 100 days post-HCT. Clinical outcomes were monitored for up to 6 years. RESULTS Cox proportional hazard models (2-tailed) adjusting for patient demographic and medical characteristics revealed that high pre-HCT sleep disruption (Pittsburgh Sleep Quality Index >9; hazard ratio [HR] = 2.74, 95% confidence interval [CI] = 1.27 to 5.92) and greater post-HCT fatigue interference (HR = 1.32, 95% CI = 1.05 to 1.66) uniquely predicted increased risk of mortality. Moderate pre-HCT sleep disruption (Pittsburgh Sleep Quality Index 6-9) predicted increased risk of relapse (HR = 1.99, 95% CI = 1.02 to 3.87). Biobehavioral symptoms did not predict cGVHD incidence. CONCLUSIONS Biobehavioral symptoms, particularly sleep disruption and fatigue interference, predicted an increased risk for 6-year relapse and mortality after HCT. Because these symptoms are amenable to treatment, they offer specific targets for intervention to improve HCT outcomes.
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Affiliation(s)
- Kelly E Rentscher
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Judith E Carroll
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Mark B Juckett
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Aimee T Broman
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - Paul J Rathouz
- Department of Population Health, University of Texas at Austin, Austin, TX, USA
| | - Peiman Hematti
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Erin S Costanzo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
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