Effects of online acceptance and commitment therapy on psychological distress and health-related quality of life among early-stage non-small cell lung cancer patients after surgery: a randomized controlled trial

Early-stage non-small cell lung cancer (NSCLC) patients may experience various psychosocial challenges during recovery after surgery, despite having undergone potentially curative treatment. These challenges may adversely affect their psychological well-being and health-related quality of life (HRQoL). Acceptance and commitment therapy (ACT), which aims to enhance psychological flexibility, may provide a promising approach to supporting patients in adapting to cancer-related experiences and postoperative recovery. Online delivery may further improve the accessibility and flexibility of psychological support. This project aims to develop and evaluate an online ACT intervention for early-stage NSCLC patients after surgery. The project will include a qualitative phase followed by a randomized controlled trial. In the qualitative phase, semi-structured individual interviews will explore patients’ psychosocial challenges, rehabilitation and supportive care needs, and preferences for psychological support during postoperative recovery. Findings from the qualitative study, together with existing evidence and the ACT framework, will inform the development and refinement of a patient-centred online ACT intervention. Subsequently, we will conduct a randomized controlled trial to evaluate the effects of the developed online ACT intervention. Eligible participants will be randomly allocated to an intervention group or a control group. The primary outcomes will be psychological distress and HRQoL. Secondary outcomes will include psychological flexibility and cancer-related symptom burden. We will collect data at baseline, post-intervention, and follow-up time points.