Skip to main content

Table 1 Phases of physical and psychological adaptation, as well as the characteristics and interventions of the six stages of ACT

From: Effects of acceptance and commitment therapy on self-management skills and psychological resilience of young and middle-aged patients underwent percutaneous transluminal coronary intervention for primary myocardial infarction: a pilot study

Stages of physical and psychological adaptation ACT stage ACT stage characteristics Interventions applied
Confusion and reflection Acceptance Guide the patients to accept the fact of disease; perceive and face the disease instead of avoiding it 1) Establish a harmonic nurse-patient relationship
2) Explain the disease conditions, listen to patient requirements, and evaluate their psychosocial responses
3) Encourage the patients to express their feelings, inform them of the importance of active cooperation with treatment, and encourage them to accept treatment with an optimistic attitude
Adaptation and reconstruction Cognitive dissociation Guide the patients to objectively and calmly recognize issues, negative feelings, and self-thoughts 1) Provide active psychological dredging, enhance communication, promote experience sharing, and guide the patients to identify the most suitable method
2) Actively evaluate patient changes, dissociate them from thoughts and anticipations, and encourage them to face various psychological activities objectively
Present consciousness Guide the patients to intentionally pay attention to the present psychological activities, physiological feelings, and external environment 1) Listen to the complaints of patients, provide approval, encourage, and support
2) Empathize with patients in their disease experience, encourage them to pay intentional attention to the current environment and their psychological status, and guide them to view life with a positive attitude, establish their value, and enhance confidence
3) Encourage the patients to believe and accept the medical arrangements without overthinking
4) Guide the patients to exempt themselves from anxieties about the disease by mindful decompression, mind emptying, book and newspaper reading, and music listening, and clarify the current status
Situational analysis Guide the patients to objectively experience the changes of physical feelings, character, emotion, and behaviors and establish the self-based perception 1) Positively communicate with the patients and guide them to objectively describe their own experience of the changes of behaviors, emotions, characters, and feelings
2) Help the patients to recall previous successful experiences of overcoming difficulties and help them understand the actual and conceptual selves through various metaphorical expressions
3) Analyze the social characters of the patients and guide them to understand their importance to society and their families
Acceptance and integration Clearing value perspective To guide patients to actively seek and identify the direction and value of their future life To communicate with patients through various methods, including writings, pictures, and videos; to encourage patients to be hopeful about their future; to help them resolve confusion about life; and to help them clarify their life values
Committed actions To decide the short- and long-term objectives with the patients and achieve changes and growth 1) Select the appropriate attitude to life and lifestyle based on the long- and short-term life goals
2) Actively work towards the goals, identify personal values, and participate in society with an optimistic and proactive attitude
Evaluation and intervention after hospital discharge Reality feelings, recognize themselves, constantly adjust, and affirm the self-value 1) To evaluate the psychological symptoms after discharge, whether there are obvious emotional fluctuations, whether there are psychological collisions in the face of the real world, and whether to take effective measures to relieve them after the stimulation of some adverse events
2) Based on the evaluation of the positive psychological intervention, encourage patients to express the real-life experience actively, guide it positively and effectively, encourage families to actively cooperate at this stage, make the patients cognitive self, accept self, correct bad emotions, and affirm self-worth, with positive attitude return to society and return to work