Keywords
Therapy
Quality of life
Terminal illness
Palliative care
Systematic review
Meta-analysis Terapia de Aceptación y Compromiso
Calidad de vida
Enfermedad terminal
Cuidados paliativos
Revisión sistemática
Meta-análisis
How to Cite
Abstract
Background: Acceptance and Commitment Therapy (ACT) is an evidence-based, process-oriented psychotherapy
that provides palliative care through compassionate, person-centered care for terminal illness. This study evaluates
the effects of ACT on quality of life (QoL) and emotional distress and examines the role of process variables (e.g.,
psychological flexibility). Method: Systematic review with meta-analysis following searches in PubMed, SCOPUS
and PsycInfo for studies measuring QoL, anxiety/depression symptoms, and process variables in ACT interventions.
Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed. Results: 13 studies
were included (1,109 participants; Mage = 61.5; 55.7% women; 6 RCTs). ACT showed significant, moderate effects for
QoL, anxiety and depression symptoms versus active controls (SMD = 0.44 to 0.62), sustained at 1-9 months followup (SMD = 0.35 to 0.56). Psychological flexibility emerged as the strongest predictor of QoL improvement. Face-toface interventions demonstrated better results than remote delivery. Conclusions: These findings support the clinical
relevance of ACT as an effective approach for addressing psychological distress and improving QoL in end-of-life
care. Key limitations include self-report bias, high heterogeneity, potential overlap between measures, publication bias
for QoL, and limited sample sizes in some analyses. High-quality trials are warranted, particularly in non-oncological
populations, caregivers, and healthcare professionals.
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