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Li S, Chen Z, Yong Y, Xie J, Li Y. Effectiveness of acceptance and commitment therapy-based interventions for improving the psychological health of parents of children with special health care needs: A systematic review and meta-analysis. Compr Psychiatry 2023; 127:152426. [PMID: 37757593 DOI: 10.1016/j.comppsych.2023.152426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE To evaluate the effectiveness of ACT-based interventions on improving the mental health of parents of children with SHCN compared to active/inactive controls and to investigate the characteristics/components of the effective interventions in the included studies. METHODS Eight databases were searched from inception to 14 February 2023. We included all randomized controlled trials (RCTs) of ACT-based interventions for parents of children with SHCN published in English or Chinese journals and dissertations reporting at least one parental mental health outcome postintervention. RESULTS Fourteen RCTs were included. The results indicated significant improvements of ACT-based interventions in the stress (Hedges' g = -0.36), depressive symptoms (g = -0.32), anxiety (g = -0.29), distress (g = -0.29), psychological flexibility (g = 0.51), mindful awareness/mindfulness abilities (g = 0.41), and confidence/self-efficacy (g = 0.30) of parents, as well as in the emotional and behavioural problems (EBP; g = -0.39) of their children with SHCN postintervention, with moderate to high certainty of evidence. Furthermore, the optimal components of ACT-based interventions, including the intervention approaches (ACT combined with another parenting technique/program), active participants (only involving parents), delivery mode (in-person) and format (group-based format), and desirable number of sessions (4-8 sessions), were identified to inform the design of future interventions/studies. CONCLUSION This review highlights the positive effects of ACT-based interventions on mental health, psychological flexibility, mindful awareness/mindfulness abilities, and confidence/self-efficacy in parents and EBP in children with SHCN. Since group-based ACT combined with a parenting technique/program was identified as the optimal effective strategy, its effects could be further examined in larger-scale RCTs with parents and children with SHCN with diverse ethnic and sociodemographic characteristics.
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Affiliation(s)
- Sini Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Zengyu Chen
- The Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Yijing Yong
- Cognition and Human Behaviour Key Laboratory of Hunan Province, Hunan Normal University, Changsha, Hunan, China
| | - Jiao Xie
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China..
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; The Xiangya Nursing School, Central South University, Changsha, Hunan, China.
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Atefi GL, de Vugt ME, van Knippenberg RJM, Levin ME, Verhey FRJ, Bartels SL. The use of Acceptance and Commitment Therapy (ACT) in informal caregivers of people with dementia and other long-term or chronic conditions: A systematic review and conceptual integration. Clin Psychol Rev 2023; 105:102341. [PMID: 37776577 DOI: 10.1016/j.cpr.2023.102341] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
Informal caregivers are the primary source of support for adults with chronic conditions and disabilities. Empirical research highlights chronic stress and other risks of adverse outcomes of caregiving. Acceptance and Commitment Therapy (ACT) is an emerging evidenced-based practice that shows promise in improving an array of outcomes, theoretically by increasing psychological flexibility as the primary process of change. Research has begun to evaluate ACT among informal caregivers of adult populations, and a systematic review is now needed to summarise this evidence base. Electronic searches from five databases, including PubMed, PsycInfo, Embase, CINAHL, and Cochrane Library, yielded an initial 7896 hits, which after screening for inclusion criteria, resulted in 21 clinical trials. Studies were coded to synthesise the feasibility, effectiveness, and quality of evidence. Findings show that ACT was reported to be largely feasible and acceptable. However, the efficacy of ACT was mixed, with a more consistent pattern for informal caregivers of people with dementia. Several methodological quality issues limited the findings. However, theoretical synthesis and preliminary evidence support the promising effect of ACT in subgroups of informal caregivers. Research on the process of change, as well as larger-scale, methodologically rigorous trials, are needed to consolidate these findings.
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Affiliation(s)
- Golnaz L Atefi
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands.
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Rosalia J M van Knippenberg
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Michael E Levin
- Department of Psychology, Utah State University, Logan, UT 84322, USA
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands; Department of Clinical Neuroscience, Karolinska Institute, Sweden
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Wright SR, Graham CD, Houghton R, Ghiglieri C, Berry E. Acceptance and commitment therapy (ACT) for caregivers of children with chronic conditions: A mixed methods systematic review (MMSR) of efficacy, process, and acceptance. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Jin X, Li H, Chong YY, Mann KF, Yao W, Wong CL. Feasibility and preliminary effects of acceptance and commitment therapy on reducing psychological distress and improving the quality of life of the parents of children with cancer: A pilot randomised controlled trial. Psychooncology 2023; 32:165-169. [PMID: 35460318 DOI: 10.1002/pon.5941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Xiaohuan Jin
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Fai Mann
- School of Continuing and Professional Education, City University of Hong Kong, Hong Kong, China
| | - Wenying Yao
- Nursing Department, Children's Hospital of Soochow University, Suzhou, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Driessens C, Mills L, Culliford D, Patel R, Lee E, Gbesemete D, Chappell H, Shaunak M, Faust SN, de Graaf H. Parental concern for clinically vulnerable child during first 18 months of the COVID pandemic. Pediatr Res 2022:10.1038/s41390-022-02371-7. [PMID: 36418484 PMCID: PMC9684768 DOI: 10.1038/s41390-022-02371-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 08/26/2022] [Accepted: 09/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The uncertainties surrounding the COVID-19 pandemic have been associated with increased parental concern. The aim of this study is to explore if this increased level of concern is associated with certain individual/household characteristics or if parents adapted to the ever-changing realities of the COVID-19 pandemic over time. METHODS This prospective study explored COVID-19 concern trajectories and associated family characteristics of 765 UK parents caring for an immunosuppressed child during the first 18 months of the pandemic using growth mixture modelling. Qualitative analysis was performed to examine in more detail the source of concern. RESULTS Four different trajectories of parental COVID-19 concern were identified. Ongoing very high concern was associated with caring for children with nephrotic or respiratory disease; having a child on an organ transplant waiting list; residency in the North of England; or parental vocational inactivity. Explicit concerns voiced by the parents generally followed national trends, but vulnerable status specific concerns were also reported. CONCLUSION Diagnosis and prescribed medication of the immunosuppressed child, geographical location, household composition, and employment status of parent were associated with the different concern trajectories. This information can be helpful in targeting psychological family care where it is most needed. IMPACT Many British parents caring for a clinically vulnerable child during the first 18 months of the COVID-19 pandemic showed high levels of concern with little sign of psychological adaptation. Consistent with findings from non-vulnerable populations, parents mentioned the impact of shielding and repeated isolation on their child's education, social life, and mental health. Unique to the clinically vulnerable population, parents were worried about child's health status, impact of delayed healthcare, and were confused by the contradictory information received from government, doctors, and media. Psychological family care can be targeted to those parents at greater risk for high levels of concern.
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Affiliation(s)
- Corine Driessens
- grid.5491.90000 0004 1936 9297NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Lynne Mills
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - David Culliford
- grid.5491.90000 0004 1936 9297NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Ravin Patel
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Emma Lee
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Diane Gbesemete
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Harry Chappell
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Meera Shaunak
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Saul N. Faust
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK ,grid.5491.90000 0004 1936 9297Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Hans de Graaf
- grid.430506.40000 0004 0465 4079NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Southampton, UK ,grid.5491.90000 0004 1936 9297Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
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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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Zhang B, Li H, Jin X, Peng W, Wong CL, Qiu D. Prevalence and factors associated with compassion satisfaction and compassion fatigue among Chinese oncology healthcare professionals: A cross-sectional survey. Asia Pac J Oncol Nurs 2021; 9:153-160. [PMID: 35494093 PMCID: PMC9052843 DOI: 10.1016/j.apjon.2021.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/07/2021] [Indexed: 01/15/2023] Open
Abstract
Objective Methods Results Conclusions
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Affiliation(s)
- Bixia Zhang
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaohuan Jin
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wenqi Peng
- Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Corresponding author.
| | - Dingrong Qiu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Corresponding author.
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Parmar A, Esser K, Barreira L, Miller D, Morinis L, Chong YY, Smith W, Major N, Church P, Cohen E, Orkin J. Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158205. [PMID: 34360497 PMCID: PMC8345967 DOI: 10.3390/ijerph18158205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/28/2021] [Accepted: 07/31/2021] [Indexed: 11/23/2022]
Abstract
Context: Acceptance and Commitment Therapy (ACT) is an emerging treatment for improving psychological well-being. Objective: To summarize research evaluating the effects of ACT on psychological well-being in children with special health care needs (SHCN) and their parents. Data Sources: An electronic literature search was conducted in PubMed, Web of Science, Ovid/EMBASE and PsycINFO (January 2000–April 2021). Study Selection: Included were studies that assessed ACT in children with SHCN (ages 0–17y) and/or parents of children with SHCN and had a comparator group. Data Extraction: Descriptive data were synthesized and presented in a tabular format, and data on relevant outcomes (e.g., depressive symptoms, stress, avoidance and fusion) were used in the meta-analyses to explore the effectiveness of ACT (administered independently with no other psychological therapy) compared to no treatment. Results: Ten studies were identified (child (7) and parent (3)). In children with SHCN, ACT was more effective than no treatment at helping depressive symptoms (standardized mean difference [SMD] = −4.27, 95% CI: −5.20, −3.34; p < 0.001) and avoidance and fusion (SMD = −1.64, 95% CI: −3.24, −0.03; p = 0.05), but not stress. In parents of children with SHCN, ACT may help psychological inflexibility (SMD = −0.77, 95% CI: −1.07, −0.47; p < 0.01). Limitations: There was considerable statistical heterogeneity in three of the six meta-analyses. Conclusions: There is some evidence that ACT may help with depressive symptoms in children with SHCN and psychological inflexibility in their parents. Research on the efficacy of ACT for a variety of children with SHCN and their parents is especially limited, and future research is needed.
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Affiliation(s)
- Arpita Parmar
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Kayla Esser
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Lesley Barreira
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON LS8 4L8, Canada; (D.M.); (W.S.)
| | - Douglas Miller
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON LS8 4L8, Canada; (D.M.); (W.S.)
| | - Leora Morinis
- Institute of Health, Policy, Management & Evaluation, Univeristy of California San Francisco, San Francisco, CA 94143, USA;
| | - Yuen-Yu Chong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Wanda Smith
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON LS8 4L8, Canada; (D.M.); (W.S.)
| | - Nathalie Major
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada;
| | - Paige Church
- Divison of Neonatology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada;
| | - Eyal Cohen
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Institute of Health, Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1P7, Canada
| | - Julia Orkin
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1P7, Canada
- Correspondence: ; Tel.: +416-813-7654
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