DISCUSSION
stroke, psychiatric, psychotic symptoms, depression, acute stroke
STROKE, ACUTE STROKE
This study found that the G‐ACT intervention significantly reduced depression in acute stroke patients when compared with the control group at post‐intervention and this difference persisted at 3 months, which echoes the findings of RCTs using G‐ACT with acute stroke patients (Niu et al., Most of the included patients were assessed as having mild depression with those having severe psychotic symptoms and who may need individual therapy or more specialized psychiatric treatments excluded from our study. The promising results suggested that G‐ACT was effective in patients with mild depression, which is similar to other reported findings (Bai et al., This study also found that significant G‐ACT intervention effects were observed for HRQoL‐MCS at post‐intervention which persisted at 3 months in acute stroke patients. However, there was no outstanding difference in the PCS scores between the two groups at any time point. The lack of effect of G‐ACT on PCS in our study was similar to Dewhurst et al. (This study assessed an ACT intervention change in psychological flexibility, and the findings indicated that G‐ACT could improve psychological flexibility significantly over time, which was similar to a review (Graham et al., The group training sessions in the study were delivered by two research nurses suggesting that the G‐ACT intervention can be delivered by non‐psychologists including nurses who provide health care for the longest time to patients. As the psychotherapy is not available for in‐patients in China, the results of our study have important clinical implications because it means nurses or other non‐psychologists can implement ACT for stroke patients to reduce depression or other symptoms. Future multicenter studies need to test this conclusion. The nurses in this study had online and face‐to‐face training from two clinical psychologists and delivered three practice sessions prior to the study, which is similar to Majumdar and Morris (