Effect of acceptance and commitment therapy on mental health and quality of life in cancer patients: A meta-analysis

doi:10.3969/j.issn.1004-583X.2024.02.001

Abstract

Abstract:

Objective To systematically evaluate the effect of acceptance and commitment therapy (ACT) on the mental health and quality of life of cancer patients. Methods Randomized clinical trials (RCTs) reporting the influence of ACT on mental health and quality of life in cancer patients were searched in the CBM, WanFang, CNKI, VIP, PubMed, Cochrane Library, Web of Science and EMbase databases, and the retrieval time was from the time of building the database to November 2022. Literature screening based on inclusion and exclusion criteria, quality assessment and data extraction were performed by two investigators. A meta-analysis was conducted using Revman5.4 software. Results A total of 14 RCTs representing 1,063 cancer patients were enrolled. Meta-analysis results showed that ACT significantly improved anxiety (SMD=-1.04, 95%CI [-1.19, -0.89], P<0.01), depression (SMD=-0.73, 95%CI[ -0.88, -0.59], P<0.01), psychological flexibility (MD=-2.17, 95%CI[-2.77, -1.57], P<0.01) and quality of life in cancer patients (MD=5.27, 95%CI [3.57, 6.98], P<0.01). Conclusion ACT can relieve anxiety and depression, improve psychological flexibility and quality of life, and positively promoting physical and mental health of cancer patients.

Key words: acceptance and commitment therapy, cancer, psychological nursing, meta-analysis

CLC Number:

R473.73

Gong Caifang, Zhao Junyu, You Chuan. Effect of acceptance and commitment therapy on mental health and quality of life in cancer patients: A meta-analysis[J]. Clinical Focus, 2024, 39(2): 101-107.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.02.001

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I2/101

Figures/Tables 9

References 37

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纳入文献	年份 (年)	癌症类型	样本量(例)		干预措施		干预时间及方式	结局指标	测量工具
纳入文献	年份 (年)	癌症类型	观察组	对照组	观察组	对照组	干预时间及方式	结局指标	测量工具
Shari等^[11]	2020	乳腺癌	30	30	ACT	常规护理	12周,1次/3周,1 h/次,面对面	①②③	HADS、AAQ-Ⅱ
Serfaty等^[12]	2018	各种类型	20	22	ACT+TC	TC	3月,8次/周,1 h/次,面对面	③④	HADS、FACT
Fernández-Rodríguez等^[14]	2020	各种类型	12	17	ACT	常规护理	3月,12次/周,90 min/次,面对面	①②③	HADS、AAQ-Ⅱ
González-Fernández等^[15]	2018	乳腺癌	12	23	ACT	常规护理	12次/周,90 min/次,面对面	①②③	HADS、AAQ-Ⅱ
Johns等^[16]	2019	乳腺癌	31	31	ACT	SE	6周, 1次/7d, 2 h/次,面对面	①②	GAD、PHQ
Li等^[17]	2022	肺癌	20	20	ACT	常规护理	1次/周,60~90 min/次,面对面+网络视频	①②④	GAD、PHQ
Mohabbat-Bahar等^[18]	2015	乳腺癌	15	15	ACT	常规护理	4周,2次/周,90 min/次,面对面	①②	BAI、BHI
周小帅^[19]	2020	乳腺癌	30	30	ACT	常规护理	2周,1次/2d,30 min/次,面对面	①②	SAS、SDS
姚晚侠等^[20]	2020	乳腺癌	140	140	ACT	常规护理	3月,1次/月,面对面+电话+微信	①②	SAS、SDS
潘虹等^[21]	2020	胰腺癌	37	42	ACT	常规护理	8周,6次/周,90 min/次,面对面	①②③	DASS、AAQ-Ⅱ
王婷婷等^[22]	2022	食管癌	50	50	ACT	常规护理	4周,面对面	①②③④	SAS、SDS、AAQ-Ⅱ、QLQ-C30
胡迎冬等^[23]	2016	乳腺癌	41	39	ACT	常规护理	2周,1次/2d,30~40 min/次,面对面	①②④	SAS、SDS、FACT
许湘华等^[24]	2019	喉癌	24	24	ACT	常规护理	术前1 d-术后5 d,面对面	③④	AAQ-Ⅱ、FACT
魏慧等^[25]	2020	直肠癌	59	59	ACT	常规护理	术前1 d-术后5 d,面对面	①②	HADS、AAQ-Ⅱ

纳入文献	年份 (年)	癌症类型	样本量(例)		干预措施		干预时间及方式	结局指标	测量工具
纳入文献	年份 (年)	癌症类型	观察组	对照组	观察组	对照组	干预时间及方式	结局指标	测量工具
Shari等^[11]	2020	乳腺癌	30	30	ACT	常规护理	12周,1次/3周,1 h/次,面对面	①②③	HADS、AAQ-Ⅱ
Serfaty等^[12]	2018	各种类型	20	22	ACT+TC	TC	3月,8次/周,1 h/次,面对面	③④	HADS、FACT
Fernández-Rodríguez等^[14]	2020	各种类型	12	17	ACT	常规护理	3月,12次/周,90 min/次,面对面	①②③	HADS、AAQ-Ⅱ
González-Fernández等^[15]	2018	乳腺癌	12	23	ACT	常规护理	12次/周,90 min/次,面对面	①②③	HADS、AAQ-Ⅱ
Johns等^[16]	2019	乳腺癌	31	31	ACT	SE	6周, 1次/7d, 2 h/次,面对面	①②	GAD、PHQ
Li等^[17]	2022	肺癌	20	20	ACT	常规护理	1次/周,60~90 min/次,面对面+网络视频	①②④	GAD、PHQ
Mohabbat-Bahar等^[18]	2015	乳腺癌	15	15	ACT	常规护理	4周,2次/周,90 min/次,面对面	①②	BAI、BHI
周小帅^[19]	2020	乳腺癌	30	30	ACT	常规护理	2周,1次/2d,30 min/次,面对面	①②	SAS、SDS
姚晚侠等^[20]	2020	乳腺癌	140	140	ACT	常规护理	3月,1次/月,面对面+电话+微信	①②	SAS、SDS
潘虹等^[21]	2020	胰腺癌	37	42	ACT	常规护理	8周,6次/周,90 min/次,面对面	①②③	DASS、AAQ-Ⅱ
王婷婷等^[22]	2022	食管癌	50	50	ACT	常规护理	4周,面对面	①②③④	SAS、SDS、AAQ-Ⅱ、QLQ-C30
胡迎冬等^[23]	2016	乳腺癌	41	39	ACT	常规护理	2周,1次/2d,30~40 min/次,面对面	①②④	SAS、SDS、FACT
许湘华等^[24]	2019	喉癌	24	24	ACT	常规护理	术前1 d-术后5 d,面对面	③④	AAQ-Ⅱ、FACT
魏慧等^[25]	2020	直肠癌	59	59	ACT	常规护理	术前1 d-术后5 d,面对面	①②	HADS、AAQ-Ⅱ

结局指标	纳入研究	异质性		效应模型	Meta分析结果
结局指标	纳入研究	P值	I²(%)	效应模型	SMD/MD	95%CI	Z值	P值
焦虑评分	11	0.36	9	固定	-0.99^*	[-1.14,-0.85]	13.62	<0.01
抑郁评分	10	0.29	16	固定	-0.68^*	[-0.83,-0.54]	9.42	<0.01
心理灵活性	6	0.95	0	固定	-2.17^#	[-2.77,-1.57]	7.11	<0.01
生活质量	4	0.10	49	固定	0.70^*	[0.43,0.97]	5.10	<0.01

结局指标	纳入研究	异质性		效应模型	Meta分析结果
结局指标	纳入研究	P值	I²(%)	效应模型	SMD/MD	95%CI	Z值	P值
焦虑评分	11	0.36	9	固定	-0.99^*	[-1.14,-0.85]	13.62	<0.01
抑郁评分	10	0.29	16	固定	-0.68^*	[-0.83,-0.54]	9.42	<0.01
心理灵活性	6	0.95	0	固定	-2.17^#	[-2.77,-1.57]	7.11	<0.01
生活质量	4	0.10	49	固定	0.70^*	[0.43,0.97]	5.10	<0.01