Effects of acceptance and commitment therapy for family caregivers of persons with dementia: a systematic review and meta-analysis protocol.

Abstract

With the rapid ageing of the global population, the number of persons with dementia (PwDs) is increasing, placing substantial psychological and physical burdens on family caregivers. Acceptance and commitment therapy (ACT), a mindfulness and values-based psychological intervention, has shown potential in improving mental health outcomes across various populations. However, its effectiveness, specifically for dementia family caregivers, remains to be systematically evaluated. This review aims to evaluate the effects of ACT on psychological outcomes (eg, depression, anxiety, psychological flexibility), caregiver burden and health-related quality of life (HRQoL) among family caregivers of PwDs. A comprehensive search of English and Chinese databases, including PubMed, Embase, Web of Science, Cochrane Library, CINAHL, PsycInfo, CNKI, CBM and Wanfang Data, will be conducted from inception to July 2025. Randomised controlled trials involving family caregivers (aged ≥18) of PwDs will be included in which ACT is delivered either alone or as a core component. Outcomes include psychological outcomes (eg, depression, anxiety, psychological flexibility), caregiver burden and HRQoL. Two reviewers will independently screen studies, extract data and assess risk of bias using the Cochrane RoB 1.0 tool. Meta-analysis will be performed using RevMan V.5.4, with mean difference or standardised mean difference calculated for continuous outcomes. Random or fixed-effects models will be applied depending on heterogeneity. Subgroup analysis and evaluation of publication bias will also be conducted where applicable. Ethical approval is not required because only published data will be used. Results will be disseminated through peer-reviewed publications and conference presentations. CRD420251127238.