Acceptance and commitment: An intervention for improving family function and emotional problems in informal caregivers of people with severe traumatic brain injury: A randomized clinical trial

Zanjani, Zahra; Hadavand, Mahtab; Omidi, Abdollah; Atoof, Fatemeh; Fakharian, Esmaeil

doi:10.4103/atr.atr_4_22

Cited by 2 publications

(6 citation statements)

References 23 publications

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“…The systematic selection procedures (Figure 1) resulted in 29 eligible RCTs conducted in 11 countries (eFigure 1 in Supplement 1), comprising 2010 participants. The median sample size was 59 (range, 18-203), the mean age of participants was 46.4 years (range, 30.5-62.0 years), and the mean percentage of women was 77% (range, 38%-100%).…”

Section: Resultsmentioning

confidence: 99%

“…The main facilitators of ACT included trained professionals (eg, psychiatrist, psychologist, counselor, nurse, and social worker; 16 studies [55%]) and trained students (eg, psychological and nursing students; 6 studies [21%]), whereas the other studies (7 [24%]) adopted a self-help approach. Individual-based (16 studies [55%]), group-based (10 studies [34%]), and mixed (a combination of individual- and group-based delivery; 3 studies [10%]) formats were used to deliver ACT. Most studies (22 [76%]) used a face-to-face modality, while the others used telephone calls, online platform, and email.…”

Section: Resultsmentioning

confidence: 99%

“…Individual-based (16 studies [55%]), group-based (10 studies [34%]), and mixed (a combination of individual- and group-based delivery; 3 studies [10%]) formats were used to deliver ACT. Most studies (22 [76%]) used a face-to-face modality, while the others used telephone calls, online platform, and email. Approximately 55% of included studies (16 studies) used an active control group.…”

Section: Resultsmentioning

confidence: 99%

“…The main facilitators of ACT included trained professionals (eg, psychiatrist, psychologist, counselor, nurse, and social worker; 16 studies [55%]) 44,[46][47][48]50,53,54,57,60,62,[64][65][66][67][68]71 and trained students (eg, psychological and nursing students; 6 studies [21%]), 49,55,58,61,69,70 whereas the other studies (7 [24%]) 45,51,52,56,59,63,72 adopted a self-help approach. Individual-based (16 studies [55%]), 45-47, 49, 51, 52, 54, 56, 57, 59, 60, 63, 65, 68, 70, 72 group-based (10 studies [34%]), 44,48,53,55,61,62,64,66,67,69 and mixed (a combination of individual-and group-based delivery; 3 studies [10%]) 50,58,71 formats were used to deliver ACT. Most studies ( 22[76%]) 44,[46][47]…”

Section: Selection Study Characteristics and Quality Of Included Studiesmentioning

confidence: 99%

“…Six of the RCTs had a low risk of bias, 50,51,53,56,62,65 16 had some concerns, 44,46,49,54,55,[57][58][59][60]63,64,[66][67][68][69]72 and 7 had a high risk of bias. 45,47,48,52,61,70,71 The risk of bias was mainly due to minimal baseline differences in the participants' characteristics, uncertainty about concealment, the use of an inappropriate analysis method without dealing with missing data, the unavailability of data for almost all participants, and the lack of a published protocol or trial registration (eFigure 2 in Supplement 1).…”

Section: Selection Study Characteristics and Quality Of Included Studiesmentioning

confidence: 99%

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Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions

Ye,

Lee,

Xue

et al. 2023

JAMA Netw Open

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ImportanceAlthough there is substantial evidence to suggest the health benefits of acceptance and commitment therapy (ACT) among informal caregivers of people with chronic health conditions, the great variation in intervention designs among published studies limits its application.ObjectivesTo identify intervention characteristics of ACT that are associated with improved psychological health and to assess the acceptability of ACT among informal caregivers.Data SourcesSeven English- and 3 Chinese-language databases without limits on publication dates, the reference lists of previous reviews, and gray literature were searched up to February 2023.Study SelectionRandomized clinical trials comparing the effect of ACT vs control groups on improving psychological health among informal caregivers.Data Extraction and SynthesisTwo reviewers independently screened searched records and extracted data from eligible studies. Random-effects meta-analysis and mixed-effects metaregression were performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed.Main Outcomes and MeasuresPsychological health outcomes (eg, depressive symptoms) measured by valid measurements and the acceptability of ACT based on identified parameters.ResultsA total of 29 studies with 2010 participants, published between 2015 and 2023, were identified. ACT showed moderate to large effect sizes for improving psychological health at postintervention assessments (Hedges g range, −0.55 [95% CI, −0.98 to −0.12] to −1.14 [95% CI, −1.83 to −0.45]) and at 1-to-3–month and 4-to-6–month follow-ups (Hedges g range, −0.47 [95% CI, −0.69 to −0.25] to −1.29 [95% CI, −2.33 to −0.24]). Multivariable metaregression analysis regarding intervention characteristics found that ACT delivered in a mixed individual- and group-based format, face-to-face, or through more intervention sessions was associated with greater improvements for experiential avoidance (face-to-face: β = −1.170 [95% CI, −2.020 to −0.319]; number of sessions: β = −0.242 [95% CI, −0.353 to −0.130]), depressive symptoms (mixed delivery format: β = −2.583 [95% CI, −4.845 to −0.321]; face-to-face: β = −1.555 [95% CI, −3.002 to −0.108]), or anxiety symptoms (face-to-face: β = −1.241 [95% CI, −2.337 to −0.146]). In general, ACT had low attrition rates (11%), and participants’ adherence (51%-80%) and satisfactory ratings (72%-95%) lend support to its acceptability.Conclusions and RelevanceThis systematic review and meta-analysis found that ACT was consistently associated with improvements in psychological health, supporting its application to improve informal care for chronic disease management. This review provides specific details on the design parameters of ACT for achieving greater efficacy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Selection Study Characteristics and Quality Of Included Studiesmentioning

confidence: 99%

Section: Selection Study Characteristics and Quality Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions

Ye,

Lee,

Xue

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

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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

Atefi,

de Vugt,

van Knippenberg

et al. 2023

Clinical Psychology Review

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Acceptance and commitment: An intervention for improving family function and emotional problems in informal caregivers of people with severe traumatic brain injury: A randomized clinical trial

Cited by 2 publications

References 23 publications

Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions

Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions

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

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