Effectiveness of Acceptance and Commitment Therapy (ACT) on Disease Acceptance for Breast Cancer Patients: Study Protocol of a Randomized Controlled Trial

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Nov 11

PMID 39527516

Authors

Wenjun Song

Nurul Izzah Shari

Jinggui Song

Ruiling Zhang

Nor Shuhada Mansor

Mohammad Farris Iman Leong Bin Abdullah

Zhaohui Zhang

Affiliations

Soon will be listed here.

Abstract

Background: Breast cancer patients face significant psychological challenges, including difficulties in accepting the diagnosis, treatment, and long-term impact of the disease. Acceptance and Commitment Therapy (ACT) has shown promise in enhancing acceptance and psychological flexibility in various populations. This study aims to investigate the effectiveness of ACT in promoting disease acceptance among breast cancer patients through a randomized controlled trial.

Methods: This study will recruit 90 breast cancer patients and randomly allocate them to an ACT intervention or control group. The ACT intervention, focusing on acceptance, mindfulness, value clarification, and committed action, will be delivered over 4 weeks. Meanwhile, the control group will receive standard care with non-therapeutic intervention. The study's primary outcome is disease acceptance, while secondary outcomes include depression, anxiety, social support, quality of life (QoL), and psychological inflexibility. Data will be collected at three points: baseline, post-intervention, and three-month follow-up. Statistical analysis will compare outcomes between groups to evaluate the effectiveness and mechanism of this intervention using covariance and mediation analysis.

Discussion: This study evaluates the effectiveness of ACT in promoting disease acceptance among breast cancer patients. It hypothesizes that the ACT group will show higher disease acceptance and improvements in social support, QoL, and psychological flexibility compared to the control group. The findings will contribute to research on psychological interventions and demonstrate ACT's effectiveness in enhancing disease acceptance.

Trial Registration: The research project is registered in the ClinicalTrials (NCT05327153).

References

Song W, Mansor N, Shari N, Azman N, Zhang R, Leong Bin Abdullah M . Validation of the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among patients with cancer in Malaysia. PLoS One. 2023; 18(11):e0293698. PMC: 10662767. DOI: 10.1371/journal.pone.0293698. View

Mohabbat-Bahar S, Maleki-Rizi F, Akbari M, Moradi-Joo M . Effectiveness of group training based on acceptance and commitment therapy on anxiety and depression of women with breast cancer. Iran J Cancer Prev. 2015; 8(2):71-6. PMC: 4411466. View

Speck R, Gross C, Hormes J, Ahmed R, Lytle L, Hwang W . Changes in the Body Image and Relationship Scale following a one-year strength training trial for breast cancer survivors with or at risk for lymphedema. Breast Cancer Res Treat. 2009; 121(2):421-30. DOI: 10.1007/s10549-009-0550-7. View

Hadlandsmyth K, Dindo L, Wajid R, Sugg S, Zimmerman M, Rakel B . A single-session acceptance and commitment therapy intervention among women undergoing surgery for breast cancer: A randomized pilot trial to reduce persistent postsurgical pain. Psychooncology. 2019; 28(11):2210-2217. PMC: 8908355. DOI: 10.1002/pon.5209. View

Hsu S, Wang H, Chu S, Yen H . Effectiveness of informational and emotional consultation on the psychological impact on women with breast cancer who underwent modified radical mastectomy. J Nurs Res. 2010; 18(3):215-26. DOI: 10.1097/JNR.0b013e3181ed57d0. View

A-Tjak J, Davis M, Morina N, Powers M, Smits J, Emmelkamp P . A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychother Psychosom. 2014; 84(1):30-6. DOI: 10.1159/000365764. View

Piotrkowska R, Kruk A, Krzeminska A, Medrzycka-Dabrowska W, Kwiecien-Jagus K . Factors Determining the Level of Acceptance of Illness and Satisfaction with Life in Patients with Cancer. Healthcare (Basel). 2023; 11(8). PMC: 10138420. DOI: 10.3390/healthcare11081168. View

Emery J, Butow P, Lai-Kwon J, Nekhlyudov L, Rynderman M, Jefford M . Management of common clinical problems experienced by survivors of cancer. Lancet. 2022; 399(10334):1537-1550. DOI: 10.1016/S0140-6736(22)00242-2. View

Guo Y, Ju Q, You M, Liu Y, Yusuf A, Soon L . Depression, anxiety and stress among metastatic breast cancer patients on chemotherapy in China. BMC Nurs. 2023; 22(1):33. PMC: 9901155. DOI: 10.1186/s12912-023-01184-1. View

10.

Aydin A, Gursoy A . Nurse-led support impact via a mobile app for breast cancer patients after surgery: a quasi-experimental study (step 2). Support Care Cancer. 2024; 32(9):598. DOI: 10.1007/s00520-024-08819-2. View

11.

Yusof K, Mahmud R, Abdullah M, Avery-Kiejda K, Rosli R . Cross-Cultural Adaptation of the Functional Assessment of Cancer Therapy-Breast (FACT-B) in Malaysian Breast Cancer Survivors. Asian Pac J Cancer Prev. 2021; 22(4):1055-1061. PMC: 8325129. DOI: 10.31557/APJCP.2021.22.4.1055. View

12.

Gonzalez-Fernandez S, Fernandez-Rodriguez C, Mota-Alonso M, Garcia-Teijido P, Pedrosa I, Perez-Alvarez M . Emotional state and psychological flexibility in breast cancer survivors. Eur J Oncol Nurs. 2017; 30:75-83. DOI: 10.1016/j.ejon.2017.08.006. View

13.

Mehnert A, Brahler E, Faller H, Harter M, Keller M, Schulz H . Four-week prevalence of mental disorders in patients with cancer across major tumor entities. J Clin Oncol. 2014; 32(31):3540-6. DOI: 10.1200/JCO.2014.56.0086. View

14.

Czerw A, Religioni U, Deptala A . Assessment of pain, acceptance of illness, adjustment to life with cancer and coping strategies in breast cancer patients. Breast Cancer. 2015; 23(4):654-61. PMC: 4911383. DOI: 10.1007/s12282-015-0620-0. View

15.

Duijts S, Faber M, Oldenburg H, van Beurden M, Aaronson N . Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors--a meta-analysis. Psychooncology. 2010; 20(2):115-26. DOI: 10.1002/pon.1728. View

16.

Mokhtari-Hessari P, Montazeri A . Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018. Health Qual Life Outcomes. 2020; 18(1):338. PMC: 7552560. DOI: 10.1186/s12955-020-01591-x. View

17.

Song W, Mansor N, Shari N, Zhang R, Leong Bin Abdullah M . Psychometric properties of the Malay version of the Illness Cognition Questionnaire among cancer patients in Malaysia. BMC Public Health. 2024; 24(1):173. PMC: 10787442. DOI: 10.1186/s12889-023-17060-1. View

18.

Janowski K, Tatala M, Jedynak T, Walachowska K . Social support and psychosocial functioning in women after mastectomy. Palliat Support Care. 2019; 18(3):314-321. DOI: 10.1017/S1478951519000774. View

19.

Fortin J, Leblanc M, Elgbeili G, Cordova M, Marin M, Brunet A . The mental health impacts of receiving a breast cancer diagnosis: A meta-analysis. Br J Cancer. 2021; 125(11):1582-1592. PMC: 8608836. DOI: 10.1038/s41416-021-01542-3. View

20.

Han J, Jin J, Kim S, Lee D, Kim S . "Struggling to Accept the New Breast as Part of My Body" - The Challenge of Immediate Breast Reconstruction in Women With Breast Cancer. Cancer Nurs. 2022; 45(4):262-270. DOI: 10.1097/NCC.0000000000001043. View