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The population of the aged has been rapidly increasing worldwide, and about 50% of them are under chronic pain by irreversible degenerative diseases. This study aimed to verify the effectiveness of ACT (Acceptance and Commitment Therapy) on pain, pain interference, and life satisfaction in people with chronic pain. In addition, this study proposed that anxiety, depression, self-efficacy, psychological inflexibility in pain, pain catastrophizing and kinesiophobia are mediating the effectiveness of ACT.
Participants of ACT program for this study comprised the elderly aged 65 and over who had been suffering from chronic pain for at least 6 months and reported their pain intensity of at least five on the VAS (Visual Analogue Scale, 0-10). During the sessions, experimental group participated in the ACT program designed by Stoddard and Wetherell(2011) and the control group received health education. After finishing eight sessions of each program, data from 25 participants in the experimental group and 27 in the control group were used for the final analysis.
The results showed that the ACT program is significantly more effective on relieving pain, pain interference, anxiety, and psychological inflexibility in pain than health education program. However, anxiety and psychological inflexibility did not have significant mediating effects on pain and pain interference.
Finally, this study has verified the curative effect of ACT for elderly people suffering from chronic pain. Therefore, Acceptance and Commitment Therapy can be used for supplementary treatment for patients with degenerative disease.
The purpose of this study was to provide an integrative review of ACT for mental health problems to identify content of program and discuss methodological strategy of intervention according to target population. According to Whittmore and Knaf’s integrative review method, this research was conducted in five stages: clarification of research problems, literature search, and quality evaluation of data, data analysis, and data description. The key words in English and Korean were used to search through seven electronic databases. 21 studies were finally included in this integrative review. ACT was used as an intervention for anxiety, depression, posttraumatic stress disorder and eating disorders and was effective in social avoidance, anxiety sensitivity, depression, dysfunctional belief and negative thinking. It was also used as an intervention for the maladjustment in adolescence to improve self-esteem and reduce behavioral problem. The six core processes of ACT are useful for people with chronic mental illness who have an ineffective avoidance strategy that avoids their symptoms and does not accept the illness. We give a suggestion that researchers develop and apply appropriate ACT for mentally ill person in hospitals.
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