Abstract: Objective To construct a group-based acceptance and commitment therapy (ACT) for elderly stroke survivors and to evaluate its application effect. Methods After literature review and group discussion, the draft of the group-based ACT intervention program for elderly stroke survivors was formed based on the Hexaflex model and qualitative findings. Fourteen experts were invited for 2 rounds of Delphi expert consultation to form a revised version. The program was further refined through pre-testing to form the final version, and it was validated in 66 elderly stroke survivors. Results The positive coefficient of experts in the two rounds of correspondence was 70% and 100%. The Ca, Cs and Cr was 0.95, 0.87, 0.91, respectively, and the Kendall's W coefficient was 0.130 and 0.126, respectively (P<0.05). The group-based ACT for elderly stroke survivors consisted of 8 modules, namely: ice-breaking journey (establishing the relationship), appreciation (acceptance), no tangle (cognitive dissociation), focus on the moment (being present), expanding the background (self-as-context), turning a stone into gold (self-approval), taking a step (committing action), and turning ice into water (sharing experience), with 40~60 min for each module. The main intervention effect, time effect, and interaction effect of the score of the Acceptance and Action Questionnaire (Second Edition), and Hamilton Depression Scale before and at the end of the intervention, and 1 month after the intervention were statistically significant in the two groups (P<0.001). Conclusion The group-based ACT for elderly stroke survivors is scientifical and applicable to reduce empirical avoidance and effectively alleviate patients' post-stroke depression.

Key words: elderly people, stroke survivors, acceptance and commitment therapy, program construction, application