OBJECTIVE: The aim of this study was to determine the feasibility, acceptability, and preliminary efficacy of EMPOWER (Enhancing and Mobilizing the POtential for Wellness and Resilience), an ultra-brief (∼2-hour), 6-module manualized psychological intervention for surrogates.
METHODS: Surrogates who reported significant anxiety and/or an emotionally close relationship with the patient (n=60) were randomized to receive EMPOWER or enhanced usual care (EUC) at one of three metropolitan hospitals. Participants completed evaluations of EMPOWER\'s acceptability and measures of psychological distress pre-intervention, immediately post-intervention, and at 1- and 3-month follow-up assessments.
RESULTS: Delivery of EMPOWER appeared feasible, with 89% of participants completing all 6 modules, and acceptable, with high ratings of satisfaction (mean=4.5/5, SD = .90). Compared to EUC, intent-to-treat analyses showed EMPOWER was superior at reducing peritraumatic distress (Cohen\'s d = -0.21, small effect) immediately post-intervention and grief intensity (d = -0.70, medium-large effect), posttraumatic stress (d = -0.74, medium-large effect), experiential avoidance (d = -0.46, medium effect), and depression (d = -0.34, small effect) 3 months post-intervention. Surrogate satisfaction with overall critical care (d = 0.27, small effect) was higher among surrogates randomized to EMPOWER.
CONCLUSIONS: EMPOWER appeared feasible and acceptable, increased surrogates\' satisfaction with critical care, and prevented escalation of posttraumatic stress, grief, and depression 3 months later.
目的:本研究的目的是确定可行性,可接受性,和EMPOWER(增强和动员健康和复原力的潜力)的初步功效,超简短(2小时),6个模块的代孕者手动心理干预。
方法:报告患者有显著焦虑和/或情感上亲密关系的代理人(n=60)在三家大都市医院之一随机接受EMPOWER或强化常规护理(EUC)。参与者完成了对EMPOWER的可接受性和干预前心理困扰措施的评估,立即干预后,以及1个月和3个月的随访评估。
结果:EMPOWER的交付似乎是可行的,89%的参与者完成了所有6个模块,并且可以接受,满意度较高(平均值=4.5/5,SD=.90)。与EUC相比,意向治疗分析显示,EMPOWER在减少创伤困扰(Cohen\'sd=-0.21,小效果)后立即干预和悲伤强度(d=-0.70,中大效果),创伤后应激(d=-0.74,中等效应),经验回避(d=-0.46,中等效应),和抑郁(d=-0.34,小效果)干预后3个月。在随机分配到EMPOWER的替代患者中,替代患者对整体重症监护的满意度较高(d=0.27,效果较小)。
结论:EMPOWER似乎可行且可接受,提高代理人对重症监护的满意度,并防止创伤后压力的升级,悲伤,3个月后出现抑郁症。