Dataset Information

Effectiveness of acceptance and commitment therapy in patients who had a stroke: a systematic review protocol.

ABSTRACT:

Introduction

Stroke is a common chronic disease with high rates of morbidity and disability and a great burden on patients. As a result, it affects daily activities of patients and causes negative emotions, which seriously affect their quality of life. As a new type of cognitive-behavioural therapy, acceptance and commitment therapy (ACT) may be useful to improve the mental health of patients who had a stroke. This study aimed to systematically evaluate the intervention effect of ACT in patients who had a stroke, which may provide further clinical evidence.

Methods and analysis

A systematic search of databases, including CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Cochrane Library, CINAHL and APA PsycArticles, will be conducted from their inception to 31 October 2022. All randomised controlled trials, quasi-experiments and case studies relevant to ACT will be included in English and Chinese. Two independent reviewers will conduct the review, with data extraction and quality evaluation. Review Manager V.5.4 will be used to assess the risk of bias and meta-analysis.

Ethics and dissemination

This systematic review does not require formal ethical approval, because all data will be analysed anonymously. The results will provide an overall review and evidence of the efficacy of ACT in patients who had a stroke. These findings will be disseminated through peer-reviewed publications.

Prospero registration number

CRD42022355629.

SUBMITTER: Xu K

PROVIDER: S-EPMC10441086 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effectiveness of acceptance and commitment therapy in patients who had a stroke: a systematic review protocol.

Xu Ke K Zhang Xiao Yan XY Ma Jun Yan JY Guo Xin X Zhu Shan-Shan SS Zhang Huimin H Sun Yu Yan YY

BMJ open 20230817 8

<h4>Introduction</h4>Stroke is a common chronic disease with high rates of morbidity and disability and a great burden on patients. As a result, it affects daily activities of patients and causes negative emotions, which seriously affect their quality of life. As a new type of cognitive-behavioural therapy, acceptance and commitment therapy (ACT) may be useful to improve the mental health of patients who had a stroke. This study aimed to systematically evaluate the intervention effect of ACT in ...[more]

PMID: 37591639

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Project description:Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., "waiting list") conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.

Project description:BACKGROUND:Anxiety conditions are debilitating and prevalent throughout the world. Acceptance and Commitment Therapy (ACT) is an effective, acceptance-based behavioral therapy for anxiety. However, there are treatment barriers (eg, financial, geographical, and attitudinal), which prevent people from accessing it. To overcome these barriers, internet-delivered ACT (iACT) interventions have been developed in recent years. These interventions use websites to deliver ACT information and skill training exercises on the Web, either as pure self-help or with therapist guidance. OBJECTIVE:This systematic review aimed to examine the therapeutic impact of iACT on all anxiety conditions. METHODS:The EMBASE, MEDLINE, ProQuest Central, PsycINFO, Scopus, and Web of Science databases were searched up to September 2018. The titles and abstracts of remaining records after deduplication were screened by 2 authors with a total of 36 full-text articles being retained for closer inspection next to eligibility criteria. Empirical studies of all designs, population types, and comparator groups were included if they appraised the impact of iACT treatment on any standardized measure of anxiety. Included studies were appraised on methodological quality and had their data extracted into a standardized coding sheet. Findings were then tabulated, and a narrative synthesis was performed because of the heterogeneity found between studies. RESULTS:A total of 20 studies met inclusion criteria. There were 11 randomized controlled trials (RCTs) and 9 uncontrolled pilot studies. Participants across all studies were adults. The anxiety conditions treated were as follows: generalized anxiety disorder (GAD), social anxiety disorder (SAD), illness anxiety disorder (IAD), and general anxiety symptoms, with or without comorbid physical and mental health problems. A total of 18 studies reported significant anxiety reduction after iACT treatment. This was observed in studies that delivered iACT with (n=13) or without (n=5) therapist guidance. The average attrition rate across all included studies during the active iACT treatment phase was 19.19%. In the 13 studies that assessed treatment satisfaction, participants on average rated their iACT experience with above average to high treatment satisfaction. CONCLUSIONS:These findings indicate that iACT can be an efficacious and acceptable treatment for adults with GAD and general anxiety symptoms. More RCT studies are needed to corroborate these early iACT findings using empirical treatments in active control groups (eg, internet-delivered cognitive behavioral therapy). This would potentially validate the promising results found for SAD and IAD as well as address the full spectrum of anxiety disorders.

Project description:BackgroundAcceptance and commitment therapy (ACT) can be effective in treating chronic pain. Despite evidence supporting the effectiveness of ACT, uncertainties remain regarding which subgroups in the chronic pain population are likely to benefit most and least. This protocol describes the application for two meta-analytic approaches, one at the level of individual participant data and the other at the level of aggregated data, from randomized controlled trials of ACT for chronic pain (ACT-CP-MA).MethodsWe will systematically conduct literature searches in CENTRAL, MEDLINE, EMBASE, PsycINFO, and trial registers. Two reviewers will independently select studies for inclusion and data extraction. ACT-CP-MA will include randomized controlled trials with ACT for chronic pain compared to control conditions for adults (≥ 18 years) with chronic pain (> 3 months). We will invite the authors of all eligible trials to share individual participant data. Outcomes will include standardized measures of pain interference, pain intensity, depression, anxiety, health-related quality of life, participants' rating of overall improvement, and ACT-related process variables. Using the Cochrane Collaboration's tool and GRADE, reviewers will independently check for risk of bias, quality of evidence, and strength of recommendations. In the individual participant data meta-analysis, we will use a one-step approach where participants are clustered with studies and data from all studies are modeled simultaneously. For analyses, we will use mixed-effects models. Additionally, we will employ a meta-analysis with aggregate data and compare the results of both meta-analyses.DiscussionThis collaborative meta-analysis of individual participant data from randomized controlled trials of ACT for chronic pain versus control conditions will demonstrate how the known benefits of ACT for chronic pain vary across different subtypes of the chronic pain population. The results of the meta-analyses will be based on a comprehensive search of multiple databases and will help to inform future clinical trials and decision-making on the use of ACT in chronic pain and improve the quality, design, and reporting of future trials in this field.Systematic review registrationPROSPERO CRD42019120901.

Project description:PurposeTo examine the effectiveness of ACT on weight (body mass index and body mass), eating behaviours (binge eating, emotional eating, external eating and restraint eating), and psychological outcomes (quality of life [QoL], depression, psychological flexibility, and weight stigma) among adults with overweight and obesity.MethodsSeven electronic databases (CINAHL, EMBASE, PubMed, PsycInfo Scopus, The Cochrane Library, and Web of Science) were searched from inception through 17 June 2022. 13 studies and 48 unique effect sizes were analyzed using random-effects models. Pooled effect estimates were calculated using weighted mean differences (WMD) and standardized mean differences expressed in Hedges' g (g). Heterogeneity was assessed using Q-statistics and interpreted using I2.ResultsACT was found to be effective in improving weight loss in terms of BMI (k = 6, WMD = - .50, 95% CI = - .90; - .11, t = - 3.25, p = .20, I2 = .0%), psychological flexibility and weight-related stigma. However, non-significant changes were found for body mass (k = 4, WMD = - 0.33 95% CI = - 1.53; 0.87, t = - .88, p = .44, I2 = .0%), binge eating (k = 4, g = - .34, 95% CI = - 1.31; 0.62, t = - 1.13, p = .34, I2 = 71.1%), emotional eating (k = 6, g = - .20, 95% CI = - 0.54; 0.15, t = - 1.47, p = .20, I2 = 45.0%), external eating (k = 5, g = - .40, 95% CI = 0.96; 0.16, t = - 1.99, p = .12, I2 = 81.8%), restraint eating (k = 3, g = .22 95% CI = - 0.57; 1.01, t = 1.19, p = .36, I2 = 69.1%), QoL (k = 3, g = .01, 95% CI = - 1.51; 1.52, t = .02, p = .99, I2 = 90.2%) and depression (k = 3, g = - .55, 95% CI = - 1.78; 0.67, t = - 1.94, p = .19, I2 = 79.9%).ConclusionACT could be effective in improving weight loss but more studies are needed to ascertain its effectiveness and the underlying mechanism by which the various components influence weight-related outcomes.Level of evidenceEvidence obtained from a systematic review and meta-analysis of existing empirical studies.

Project description:RationaleChronic health conditions (CHCs) are costly and difficult to manage. Patients often struggle with behavioral adherence to complex treatment regimens and experience psychiatric distress. Acceptance and Commitment Therapy (ACT) is a transdiagnostic behavioral approach that aims to improve functioning and quality of life (QoL), which are important treatment outcomes for this population. Preliminary efficacy of multi-session ACT in patients with CHCs has been demonstrated, and single-session ACT interventions have since been developed to increase feasibility, acceptability, and accessibility. The purpose of this systematic review and meta-analysis was to describe the literature on single-session ACT intervention studies in CHC populations with regards to (1) study design and methodology, (2) patient characteristics and conditions targeted, and (3) efficacy for outcomes across various domains, using narrative and quantitative methods.MethodsPsycINFO, PubMed, and Web of Science were systematically searched in August 2020. Studies of single-session ACT interventions in adult patients with CHCs that reported quantitative outcomes in any of the following domains were included: (a) functioning and related domains (e.g., disability, QoL, well-being); (b) mental health; (c) physical health; (d) ACT processes. Both controlled and uncontrolled studies were included. Study quality was assessed using the Psychotherapy Outcome Study Methodology Rating Scale (POMRF). Between-group random effects meta-analysis was conducted on general functioning outcomes.ResultsFourteen manuscripts reporting outcomes from 13 studies (N = 793) met inclusion criteria. Ten studies were identified by their authors as pilot or feasibility trials. Eight studies used comparison or control groups. Twelve studies delivered the ACT content in workshop format. Studies recruited for a variety of conditions. Narrative review found that between- and within-group effect sizes showed generally positive results favoring single-session ACT overall (69%), especially for measures of functioning and related domains (88%), mental health (67%), and ACT processes (73%). Meta-analysis found that ACT did not significantly outperform comparison groups on measures of general functioning (Hedges' g: -0.51, 95% confidence interval: [-1.19, 0.16]; I 2 = 86%; K = 5) despite a medium-sized pooled effect.DiscussionUse of single-session ACT interventions in CHC populations is an emergent field. There is preliminary evidence for the acceptability, feasibility, and efficacy of these interventions, which provides support for further testing in fully-powered RCTs. Additional RCTs will enable larger meta-analyses and stronger conclusions about efficacy. Recommendations for future trials are provided.

Dataset Information

Effectiveness of acceptance and commitment therapy in patients who had a stroke: a systematic review protocol.

Introduction

Methods and analysis

Ethics and dissemination

Prospero registration number

Publications

Effectiveness of acceptance and commitment therapy in patients who had a stroke: a systematic review protocol.

Similar Datasets

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