Gu Yunfan, Duan Mingyu, Huang Yanyan, Hu Maorong, Bao Mengjie, Yang Fang
Jiangxi University of Chinese Medicine, NO.1688 Meiling Avenue, Nanchang, 330006, Jiangxi Province, China.
Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China.
Sci Rep. 2025 Jul 2;15(1):22621. doi: 10.1038/s41598-025-07280-3.
To determine the effect of acceptance and commitment therapy (ACT) on improving the mental health of caregivers of cancer patients and to identify key intervention methods that enhance the efficacy of ACT. A computer search was conducted in PubMed, the Cochrane Library, CINAHL, Embase, Web of Science, CNKI, Wanfang, and Weipu, with the search period from the establishment of the database to July 31, 2024. Two researchers independently screened the literature, extracted the data, and assessed the quality of the included studies via RevMan 5.4 and Stata 14 software for meta-analysis. A total of 8 randomized controlled trials involving 675 caregivers were included. The effect size of ACT in improving mental health after intervention ranged from [SMD = - 0.41, 95% CI (- 0.59, - 0.23)] to [SMD = - 1.22, 95% CI (- 2.28, - 0.15)], and the effect size for mental health at follow-up ranged from [SMD = - 0.49, 95% CI (- 1.18, 0.20)] to [SMD = - 0.80, 95% CI (- 1.52, - 0.07)]. Subgroup analysis based on different outcome indicators revealed that ACT treatment in a hospital setting improved caregivers' anxiety [SMD = - 1.45, 95% CI (- 1.72, - 1.15)], depression [SMD = - 1.07, 95% CI (- 1.89, - 0.25)], and increased psychological flexibility at follow-up [SMD = - 1.42, 95% CI (- 1.80, - 1.05)]. Using face-to-face intervention methods improved patients' negative emotions (anxiety [SMD = - 1.44, 95% CI (- 1.72, - 1.15)], depression [SMD = - 1.07, 95% CI (- 1.89, - 0.25)], and psychological flexibility [SMD = - 1.42, 95% CI (- 1.80, - 1.05)]). Combining ACT with conventional psychological care further enhanced efficacy (anxiety [SMD = - 1.44, 95% CI (- 1.72, - 1.15)], depression [SMD = - 1.07, 95% CI (- 1.89, - 0.25)], and psychological flexibility [SMD = 0.33, 95% CI (0.15, 0.51)]). Additionally, the overall attrition rate for ACT treatment was low (18%), indicating a high acceptance of ACT among caregivers. Acceptance and commitment therapy can improve anxiety and depression in cancer caregivers, alleviate stress symptoms, and enhance their psychological flexibility. Moreover, caregivers show a high level of acceptance for this therapy, making it applicable in the psychological treatment of cancer caregivers.
为确定接受与承诺疗法（ACT）对改善癌症患者照料者心理健康的效果，并找出增强ACT疗效的关键干预方法。于PubMed、Cochrane图书馆、CINAHL、Embase、Web of Science、中国知网、万方和维普进行计算机检索，检索期从各数据库建库至2024年7月31日。两名研究人员独立筛选文献、提取数据，并通过RevMan 5.4和Stata 14软件评估纳入研究的质量以进行荟萃分析。共纳入8项涉及675名照料者的随机对照试验。ACT干预后改善心理健康的效应量范围为[标准化均数差（SMD）=-0.41，95%可信区间（CI）（-0.59，-0.23）]至[SMD=-1.22，95%CI（-2.28，-0.15）]，随访时心理健康的效应量范围为[SMD=-0.49，95%CI（-1.18，0.20）]至[SMD=-0.80，95%CI（-1.52，-0.07）]。基于不同结局指标的亚组分析显示，在医院环境中进行ACT治疗可改善照料者的焦虑[SMD=-1.45，95%CI（-1.72，-1.15）]、抑郁[SMD=-1.07，95%CI（-1.89，-0.25）]，并在随访时提高心理灵活性[SMD=-1.42，95%CI（-1.80，-1.05）]。采用面对面干预方法可改善患者的负性情绪（焦虑[SMD=-1.44，95%CI（-1.72，-1.15）]、抑郁[SMD=-1.07，95%CI（-1.89，-0.25）]及心理灵活性[SMD=-1.42，95%CI（-1.80，-1.05）]）。将ACT与传统心理护理相结合可进一步提高疗效（焦虑[SMD=-1.44，95%CI（-1.72，-1.15）]、抑郁[SMD=-1.07，95%CI（-1.89，-0.25）]及心理灵活性[SMD=0.33，95%CI（0.15，0.51）]）。此外，ACT治疗的总体失访率较低（18%），表明照料者对ACT的接受度较高。接受与承诺疗法可改善癌症照料者的焦虑和抑郁，缓解应激症状，并增强其心理灵活性。此外，照料者对该疗法接受度较高，使其适用于癌症照料者的心理治疗。
