Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Application of Acceptance and Commitment Therapy (ACT) in Hospice and Palliative Care Settings

  • So-Young Park (Ewha Institute for Age Integration Research, Ewha Womans University)
  • Received : 2023.07.12
  • Accepted : 2023.07.19
  • Published : 2023.09.01
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Abstract

Many terminally ill cancer patients grapple with a range of physical, psychological, and social challenges. Therefore, it is critical to offer effective psychological interventions to assist them in managing these issues and enhancing their quality of life. This brief communication provides a concise overview of acceptance and commitment therapy (ACT), along with empirical evidence of its application for patients, caregivers, and healthcare professionals in hospice and palliative care settings and an overview of future directions of ACT interventions in South Korea. ACT, a third-wave type of cognitive behavioral therapy, is a model of psychological flexibility that promotes personal growth and empowerment across all life areas. Currently, there is substantial evidence from overseas supporting the effectiveness of ACT on health-related outcomes among patients with various diseases, caregivers, and healthcare professionals. The necessity and significance of conducting ACT-based empirical research in hospice and palliative care settings in South Korea are discussed.

Keywords

Acknowledgement

This study was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2021S1A5B5A16076311).

References

  1. Jung KW, Kang MJ, Park EH, Yun EH, Kim HJ, Kong HJ, et al. Prediction of cancer incidence and mortality in Korea, 2023. Cancer Res Treat 2023;55:400-7. https://doi.org/10.4143/crt.2023.448
  2. Statistics Korea. Causes of death statistics in 2021 [Internet]. Daejeon: Statistics Korea; 2022 [cited 2023 Jul 7]. Available from: http://kostat.go.kr.
  3. Kim K, Park B, Gu B, Nam EJ, Kye SH, Choi JY. The national hospice and palliative care registry in Korea. Epidemiol Health 2022;44:e2022079.
  4. Santiago-Palma J, Payne R. Palliative care and rehabilitation. Cancer 2001;92(4 Suppl):1049-52. https://doi.org/10.1002/1097-0142(20010815)92:4+<1049::AID-CNCR1418>3.0.CO;2-H
  5. Rome RB, Luminais HH, Bourgeois DA, Blais CM. The role of palliative care at the end of life. Ochsner J 2011;11:348-52.
  6. Bradly N, Lloyd-Williams M, Dowrick C. Effectiveness of palliative care interventions offering social support to people with life-limiting illness-A systematic review. Eur J Cancer Care 2018;27:e12837.
  7. Graham CD, Gouick J, Krahe C, Gillanders D. A systematic review of the use of acceptance and commitment therapy (ACT) in chronic disease and long-term conditions. Clin Psychol Rev 2016;46;46-58. https://doi.org/10.1016/j.cpr.2016.04.009
  8. Li H, Wong CL, Jin X, Chen J, Chong YY, Bai Y. Effects of acceptance and commitment therapy on health-related outcomes for patients with advanced cancer: a systematic review. Int J Nurs Stud 2021;115:103876.
  9. Hayes SC, Hayes LJ, Reese HW, Sarbin TR. Varieties of scientific contextualism. Reno, NV:Context Press;c1993.
  10. Hayes SC, Barnes-Holmes D, Roche, B. Relational frame theory: a post-Skinnerian account of human language and cognition. New York, NY:Kluwer Academic/Plenum;2001.
  11. Hayes SC, Strosahl K. A practical guide to acceptance and commitment therapy. New York, NY:Springer;c2004.
  12. Luoma JB, Hayes SC, Walser, RD. Learning ACT: an acceptance and commitment therapy skills-training manual for therapists. 2nd ed. Oakland, CA:Context Press; 2017.
  13. Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavior therapy. Behav Ther 2004;35:639-65. https://doi.org/10.1016/S0005-7894(04)80013-3
  14. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther 2006; 44:1-25. https://doi.org/10.1016/j.brat.2005.06.006
  15. Harris R. ACT made simple: an easy-to-read primer on acceptance and commitment therapy. Oakland, CA:New Harbinger Publ;2009.
  16. National Institute on Aging. What are palliative care and hospice care? [Internet]. Gaithersburg, MD: National Institute on Aging; 2021 [cited 2023 Jul 1]. Available from: https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care.
  17. Woo JA, Maytal G, Stern TA. Clinical challenges to the delivery of end-of-life care. Prim Care Companion J Clin Psychiatry 2006;8:367-72. https://doi.org/10.4088/PCC.v08n0608
  18. Rodin G, An E, Shnall J, Malfitano, C. Psychological interventions for patients with advanced disease: Implications for oncology and palliative care. J Clin Oncol 2020;38:885-904. https://doi.org/10.1200/JCO.19.00058
  19. Warth M, Kessler J, Koehler F, Aguilar-Raab C, Bardenheuer HJ, Ditzen B. Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis. Palliat Med 2019;33:332-45. https://doi.org/10.1177/0269216318818011
  20. Fang P, Tan L, Cui J, Yu L. Effectiveness of acceptance and commitment therapy for people with advanced cancer: a systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2023;79:519-38. https://doi.org/10.1111/jan.15543
  21. Serfaty M, Armstrong M, Vickerstaff V, Davis S, Gola A, McNamee P, Omar RZ, et al. Acceptance and commitment therapy for adults with advanced cancer (CanACT): A feasibility randomised controlled trial. Psychooncology 2019;28:488-96. https://doi.org/10.1002/pon.4960
  22. Hulbert-Williams NJ, Norwood SF, Gillanders D, Finucane, AM, Spiller J, Strachan J, et al. Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer. BMC Palliat Care 2021;20:96.
  23. Clark PG, Brethwaite DS, Gnesdiloff S. Providing support at time of death from cancer: Results of a 5-year post-bereavement group study. J Soc Work End Life Palliat Care 2011;7:195-215. https://doi.org/10.1080/15524256.2011.593156
  24. Mosher CE, Secinti E, Wu W, Kashy DA, Kroenke K, Bricker JB, et al. Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial. Palliat Med 2022;36:1104-17. https://doi.org/10.1177/02692163221099610
  25. Davis EL, Deane FP, Lyons GC. An acceptance and commitment therapy self-help intervention for carers of patients in palliative care: Protocol of a feasibility randomized controlled trial. J Health Psychol 2019;24:685-704. https://doi.org/10.1177/1359105316679724
  26. Davis EL, Deane FP, Lyons GC, Barclay GD, Bourne J, Connolly V. Feasibility randomized controlled trial of a self-help acceptance and commitment therapy intervention for grief and psychological distress in carers of palliative care patients. J Health Psychol 2020;25:322-39. https://doi.org/10.1177/1359105317715091
  27. Waters CS, Frude N, Flaxman PE, Boyd J. Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist-controlled evaluation of an ACT workshop in a routine practice setting. Br J Clin Psychol 2018;57:82-98. https://doi.org/10.1111/bjc.12155
  28. Finucane A, Hulbert-Williams NJ, Swash B, Spiller JA, Lydon B, Gillanders D. Research evaluating staff training online for resilience (RESTORE): Protocol for a single-arm feasibility study of an online acceptance and commitment therapy intervention to improve staff wellbeing in palliative care settings [version 2; peer review: 2 approved]. AMRC Open Res 2022;3:26.