P-71 Acceptance and commitment therapy (ACT) for people with palliative care needs, their caregivers and staff involved in their care: a systematic scoping review

Background/Introduction

People with advanced progressive illness are likely to develop psychological co-morbidities, such as fear of dying, being a burden to others, and existential distress. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy aimed at improving wellbeing and promoting values-based living and acceptance. There is evidence for its effectiveness for people with a range of psychiatric disorders and health problems. Evidence in palliative care settings is emerging.

Objectives

To explore evidence for Acceptance and Commitment Therapy for people with palliative care needs, their informal caregivers, and staff involved in their care.

Methods

A systematic scoping review was undertaken using four databases (Medline, PsychInfo, Embase and Amed), with relevant MeSH terms and key words from January 1999 to June 2021. Three research registries were also searched.

Results

1622 records were identified, 85 articles underwent full text review and 20 were included in the final set. Thirteen studies examined ACT for patients and showed a reduction in anxiety and depressive symptoms, fatigue interference, pain interference and improvements in physical status post ACT intervention. Four studies examined ACT for informal caregivers and showed a reduction in anxiety and depressive symptoms, and improvements in valued living and grief. One study focused on formal caregivers of people with dementia, reported reductions in anxiety, depressive symptoms and burnout following an ACT intervention. Two studies involving bereaved people found that increased acceptance led to valued living and reductions in anticipatory grief.

Conclusion

Preliminary evidence suggests that Acceptance and Commitment Therapy can improve anxiety, depression, sleep, physical symptoms and quality of life for people with advanced progressive illness; and is beneficial for informal caregivers and professionals. Future research is needed to strengthen the evidence base using larger samples, involving a control group and including outcomes that assess effectiveness over time.