The Effectiveness of Acceptance-Commitment Therapy (ACT) on Perceived Stress, Symptoms of Depression, and Marital Satisfaction in Women With Breast Cancer

Abstract

Background: Breast cancer is a completely heterogeneous disease caused by interaction of factors, such as genetic and environmental risks leading to a progressive accumulation of genetic and epigenetic changes in breast cancer cells. Moreover, it deeply affects patients' mental and social health. The present study aimed at examining the effect of group commitment-acceptance treatment on perceived stress, symptoms of depression, and marital satisfaction in women with breast cancer. Methods: The present research was a Randomized Controlled Trial (RCT), the study population of which consisted of women with breast cancer referred to Avicenna Research Institute in Tehran, Iran. The participants were selected randomly using random sampling method and Morgan table, and they were assigned to 2 groups of trial (20 individuals) and control (20 individuals). The trial group underwent 8 sessions (each taking 2 hours) for 1 month and received therapy in mind empowerment clinic based on acceptance and commitment, but the control group received no therapy except the routine management. Both groups were examined in terms of psychology using standardized questionnaires. Afterwards, the collected data were analyzed using mean and standard deviation, t-test, univariate analysis of covariance, and multivariate analysis of covariance by employment of SPSS software. Results: The results of analysis of covariance indicated that the performed therapy improved the level of perceived stress, symptoms of depression, and marital satisfaction in the trial group. The calculated eta-squared (0.40) indicated that 40% of individual differences in post test scores of perceived stress, marital satisfaction, and symptoms of depression is related to ACT. In addition, the results of univariate analysis of covariance indicated that 48% of individual differences in scores of perceived stress, 63% of individual differences in scores of marital satisfaction, and 58% of individual differences in scores of symptoms of depression were related to ACT. Conclusions: The results of the present study show that acceptance-commitment group therapy is effective and productive in reduction of psychological problems of women with breast cancer. The findings of this study, in general, provide an experimental support for ACT in terms of reduction of psychological problems of patients with cancer.