psychosocial intervention

心理社会干预
  • DOI:
    文章类型: Journal Article
    神经外伤是指由外力引起的头部或脊柱损伤。神经创伤护理需要专家的协调团队合作,包括心理护理作为多学科治疗团队的一部分。神经创伤学领域的心理干预旨在解决与头部或脊柱损伤相关的心理后果和挑战。这些干预措施在危机干预中起着至关重要的作用,促进复苏,提高生活质量,并支持个人及其家庭应对神经创伤的心理影响。严重的身体伤害总是会造成严重的心理后果,无论是短期还是长期。严重事故是突然发生的,出乎意料的,往往是直接危及生命的事件,超出了个人的反应能力,并可能造成潜在的危机反应,包括自杀风险,以及心理障碍的发展,在大多数情况下,急性应激障碍,适应障碍和创伤后应激障碍。神经创伤的心理干预通常由一个多学科团队提供,其中可能包括心理学家,精神病医生,社会工作者,和其他医疗保健专业人员。这些干预措施是根据每个人的独特需求和情况量身定制的,为了减少心理症状,促进心理健康,调整,以及神经创伤后的整体恢复。至关重要的是,不仅是经历过严重身体创伤的患者,而且他们的家庭成员也可以获得专家的心理支持。这项研究总结了在重症监护病房治疗神经损伤患者期间的心理干预措施。
    Neurotrauma means head or spine injury caused by an external force. Neurotraumatology care requires coordinated teamwork on the part of specialists, including psychological care as part of the multidisciplinary treatment team. Psychological interventions in the field of neurotraumatology aim to address the psychological consequences and challenges associated with head or spine injury. These interventions play a vital role in crisis intervention, promoting recovery, enhancing quality of life, and supporting individuals and their families in coping with the psychological impact of neurotrauma. Serious physical injuries always cause severe psychological consequences, both in short and long term. A critical accident is a sudden, unexpected, often directly life-threatening event that exceeds the individual\'s ability to respond and can create a potential crisis response, including suicidal risk, as well as the development of psychological disorders, in most cases acute stress disorder, adjustment disorder and post-traumatic stress disorder. Psychological interventions in neurotraumatology are often provided by a multidisciplinary team that may include psychologists, psychiatrists, social workers, and other healthcare professionals. These interventions are tailored to the unique needs and circumstances of each individual, with the goal of reducing psychological symptomps, promoting psychological well-being, adjustment, and overall recovery following neurotrauma. It is essential that not only patients who have experienced severe physical trauma, but also their family members have access to expert psychological support. This study summarizes psychological interventions during the treatment of neurotaruma patients at the intensive care unit.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:“健康母亲健康婴儿”(HMHB)研究是第三阶段,在圣家庭医院(HFH)与拉瓦尔品第医科大学(RMU)联合进行的单盲随机临床试验。我们旨在研究基于认知行为治疗原则的专门心理社会方法的中介,针对经历焦虑的孕妇。HMHB干预可有效治疗围产期焦虑症状并预防未来的抑郁发作。
    方法:该试验将参与者随机分为两组:HMHB干预或增强常规护理(EUC)。遵循世界卫生组织的指导方针。HMHB干预措施包括加强社会支持网络的战略,改善母婴联系和处理人际冲突的策略,经济挑战,以及使用压力管理技术和文化共鸣插图的社会性别偏好。参与者在三个关键时间点进行了严格的数据收集:基线,妊娠晚期,产后6周。主要结果是分娩后6周使用医院焦虑和抑郁量表(HADS)进行焦虑症状严重程度评分。四个潜在的调解人-社会支持,行为激活,感知压力,和怀孕经验-在妊娠晚期评估。
    结果:共有1200名参与者被随机分配到HMHB和EUC组。在六周的随访时间点,EUC组仍有379名参与者,和387继续在HMHB组。干预后,HMHB参与者在产后焦虑和抑郁评分方面表现出显着改善。中介分析显示,社会支持和妊娠麻烦是干预对产后焦虑结局的影响的重要媒介,而只有社会支持成为抑郁症结局的重要中介。
    结论:HMHB干预在改善孕妇的焦虑和抑郁评分方面显示出良好的效果。重要的调解效果表明,针对社会支持和管理与妊娠相关的麻烦对于最佳干预效果的重要性。
    BACKGROUND: The \"Healthy Mother Healthy Baby\" (HMHB) study is a phase three, single-blind randomized clinical trial conducted at Holy Family Hospital (HFH) in association with Rawalpindi Medical University (RMU). We aimed to examine the mediators of a specialized psychosocial approach based on Cognitive Behavioural Therapy principles, targeting pregnant women experiencing anxiety. The HMHB intervention was effective in treating perinatal anxiety symptoms and preventing future depressive episodes.
    METHODS: The trial randomized participants into two arms: the HMHB intervention or Enhanced Usual Care (EUC), following World Health Organization guidelines. The HMHB intervention comprised strategies to strengthen social support networks, improving mother-baby bonding and strategies to deal with interpersonal conflicts, economic challenges, and societal gender preferences using cognitive and behavioural techniques and culturally resonant illustrations. Participants underwent rigorous data collection at three pivotal timepoints: baseline, third trimester, and 6-weeks postnatal. The primary outcome was anxiety symptom severity scores using the Hospital Anxiety and Depression Scale (HADS) at 6-weeks post-childbirth. Four potential mediators - social support, behavioural activation, perceived stress, and pregnancy experience - were assessed in the third trimester of pregnancy.
    RESULTS: A total of 1200 participants were randomized to the HMHB and EUC arms. In the six-week follow-up time point, 379 participants remained in the EUC group, and 387 continued in the HMHB group. Post-intervention, HMHB participants displayed significant improvements in postnatal anxiety and depression scores. Mediation analyses revealed social support and pregnancy hassles as significant mediators of the intervention\'s effect on postnatal anxiety outcomes, while only social support emerged as a significant mediator for depression outcomes.
    CONCLUSIONS: The HMHB intervention showed promising results in improving anxiety and depression scores among pregnant women. Significant mediation effects suggest the importance of targeting social support and managing pregnancy-related hassles for optimal intervention effectiveness.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:由于存在多种合并症和非特异性症状,老年人在寻求急诊科(ED)的护理时可能面临挑战。社会心理护理是帮助改善该人群ED护理的可能目标。数字医疗技术可以在紧急情况下实施,以改善社会心理护理的提供。然而,目前尚不清楚,对于向ED就诊的老年人实施数字化心理社会干预措施,存在哪些障碍和促进因素.因此,范围审查旨在确定这些障碍和促进者是什么。
    方法:范围审查将根据JoannaBriggsInstitute指南进行,并将使用系统审查的首选报告项目和范围审查的荟萃分析扩展(PRISMA-ScR)清单。Medline数据库,Embase,将搜索PsycINFO和Scopus。搜索策略将与专业研究图书馆员协商制定,涵盖三个关键概念:ED,数字健康技术和老年人。此外,谷歌学者搜索的前100个点击量将被筛选包括在内。我们将包括定性和定量研究,调查社会心理护理的ED数字干预措施,其中主要重点是观点,态度,患者的经验和看法,家庭和工作人员。提取所有数据后,分析和综合将遵循“最佳框架综合”方法,理论领域框架将用于识别障碍和促进者。
    背景:本范围审查不需要伦理批准,因为只有公开可用的数据将被分析和评估。范围审查的结果将通过同行评审的出版物和会议介绍来传播。
    BACKGROUND: Older adults can face challenges when seeking care from emergency departments (EDs) due to presenting with multiple comorbidities and non-specific symptoms. Psychosocial care is a possible target to help improve ED care for this population. It is possible that digital health technologies can be implemented within emergency settings to improve the provision of psychosocial care. However, it is unclear what the barriers and facilitators are to implementing digital psychosocial interventions for older adults presenting to the ED. Therefore, the scoping review aims to determine what are these barriers and facilitators.
    METHODS: The scoping review will be conducted in line with the Joanna Briggs Institute guidelines and will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The databases Medline, Embase, PsycINFO and Scopus will be searched. The search strategy will be developed in consultation with a specialist research librarian and will cover three key concepts: EDs, digital health technologies and older adults. Additionally, the first 100 hits of a Google Scholar search will be screened for inclusion. We will include both qualitative and quantitative studies that investigate ED digital interventions for psychosocial care where the primary focus is the views, attitudes, experiences and perceptions of patients, families and staff. After extracting all data, analysis and synthesis will follow the \'best-fit framework synthesis\' approach and the Theoretical Domains Framework will be used to identify barriers and facilitators.
    BACKGROUND: Ethics approval is not required for this scoping review since only publicly available data will be analysed and appraised. The findings of the scoping review will be disseminated through peer-reviewed publications and conference presentations.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    这项研究旨在开发一种用户友好的决策工具,以探索针对马拉维常见围产期心理健康问题的妇女进行规模筛查和社会心理干预的不同选择的成本和经济后果的国家特定估计。我们使用与专家迭代建立的结构和参数估计开发了一个简单的仿真模型,根据已发表的试验,国际数据库和资源,统计数据,最佳实践指导和干预手册。该模型预计2022年至2026年的年度成本和投资回报。研究的视角是社会的,包括卫生支出和生产力损失。以健康相关生活质量为形式的结果以残疾调整寿命年衡量,被转换成货币价值。经济后果包括干预发生的当年发生的后果。结果表明,净收益在开始时相对较小,但随着时间的推移而增加,因为学习效果导致更多的女性被识别并接受(成本)有效的治疗。对于首先由卫生专业人员(例如助产士)提供筛查,然后由受过培训和监督的志愿者在小组和个人会议中以相等比例提供第二次筛查和干预措施的情况,以及在诊所和社区环境中,2022年的总成本为66万美元,健康福利为36万美元。到2026年,费用增加到103万美元,健康福利增加到93万美元。净收益从2022年的3.5万美元增加到2026年的52万美元,投资回报率从1.05增加到1.45。敏感性分析的结果表明,正的净收益结果对工作人员薪金的增加高度敏感。这项研究证明了开发经济决策工具的可行性,该工具可供当地决策者和影响者使用,以告知对孕产妇心理健康的投资。
    This study sought to develop a user-friendly decision-making tool to explore country-specific estimates for costs and economic consequences of different options for scaling screening and psychosocial interventions for women with common perinatal mental health problems in Malawi. We developed a simple simulation model using a structure and parameter estimates that were established iteratively with experts, based on published trials, international databases and resources, statistical data, best practice guidance and intervention manuals. The model projects annual costs and returns to investment from 2022 to 2026. The study perspective is societal, including health expenditure and productivity losses. Outcomes in the form of health-related quality of life are measured in Disability Adjusted Life Years, which were converted into monetary values. Economic consequences include those that occur in the year in which the intervention takes place. Results suggest that the net benefit is relatively small at the beginning but increases over time as learning effects lead to a higher number of women being identified and receiving (cost‑)effective treatment. For a scenario in which screening is first provided by health professionals (such as midwives) and a second screening and the intervention are provided by trained and supervised volunteers to equal proportions in group and individual sessions, as well as in clinic versus community setting, total costs in 2022 amount to US$ 0.66 million and health benefits to US$ 0.36 million. Costs increase to US$ 1.03 million and health benefits to US$ 0.93 million in 2026. Net benefits increase from US$ 35,000 in 2022 to US$ 0.52 million in 2026, and return-on-investment ratios from 1.05 to 1.45. Results from sensitivity analysis suggest that positive net benefit results are highly sensitive to an increase in staff salaries. This study demonstrates the feasibility of developing an economic decision-making tool that can be used by local policy makers and influencers to inform investments in maternal mental health.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:慢性疼痛会增加处方阿片类药物滥用或阿片类药物使用障碍(OUD)的风险。需要非药物治疗来双重解决疼痛和阿片类药物风险。基于移动和在线的减轻疼痛干预(MOBILE救济)研究的目的是比较一次会议,基于视频,针对慢性疼痛的按需数字疼痛缓解技能干预(“授权救济”(ER);为有阿片类药物滥用或阿片类药物滥用/OUD风险的人量身定制)到一次会议数字健康教育干预(“生活更好”;没有疼痛管理技能)。
    方法:MOBILERelief是一项国际在线随机对照临床试验。研究参与者是患有慢性疾病的成年人,非癌性疼痛(≥6个月),每日疼痛强度≥3/10,服用≥10吗啡等效日剂量,当前阿片类药物滥用指标评分≥6。通过临床医生推荐和诊所广告招募参与者。研究程序包括电子资格筛选,知情同意,自动1:1随机分配到治疗组,基线度量,接受指定的数字治疗和6次为期3个月的治疗后调查。研究人员将在基线和治疗后1个月和3个月致电参与者,以验证阿片类药物处方。主要的统计分析将包括协方差分析和重复测量回归的混合效应模型。
    结果:主要结果是自我报告的疼痛灾难,疼痛强度,疼痛干扰,治疗后1个月和3个月的阿片类药物渴望和阿片类药物滥用。我们将确定ER的可行性(≥50%的参与者参与度,≥70%治疗评价等级)。我们假设ER组在减少治疗后1个月的多原发疼痛结局和治疗后1个月和3个月的阿片类药物结局方面将优于LivingBetter组。
    背景:研究方案已获得斯坦福大学医学院机构审查委员会(IRB61643)的批准。我们将在同行评审的期刊上发表结果;国家药物滥用研究所(资助者)和MOBILE救济参与者将收到结果摘要。
    背景:NCT05152134。
    BACKGROUND: Chronic pain increases the risk of prescription opioid misuse or opioid use disorder (OUD). Non-pharmacological treatments are needed to dually address pain and opioid risks. The purpose of the Mobile and Online-Based Interventions to Lessen Pain (MOBILE Relief) study is to compare a one-session, video-based, on-demand digital pain relief skills intervention for chronic pain (\'Empowered Relief\' (ER); tailored to people at risk for opioid misuse or with opioid misuse/OUD) to a one-session digital health education intervention (\'Living Better\'; no pain management skills).
    METHODS: MOBILE Relief is an international online randomised controlled clinical trial. Study participants are adults with chronic, non-cancer pain (≥6 months) with daily pain intensity ≥3/10, taking ≥10 morphine equivalent daily dose and score ≥6 on the Current Opioid Misuse Measure. Participants are recruited through clinician referrals and clinic advertisements. Study procedures include electronic eligibility screening, informed consent, automated 1:1 randomisation to the treatment group, baseline measures, receipt of assigned digital treatment and six post-treatment surveys spanning 3 months. Study staff will call participants at baseline and 1-month and 3 months post-treatment to verify the opioid prescription. The main statistical analyses will include analysis of covariance and mixed effects model for repeated measurements regression.
    RESULTS: Primary outcomes are self-reported pain catastrophising, pain intensity, pain interference, opioid craving and opioid misuse at 1-month and 3 months post-treatment. We will determine the feasibility of ER (≥50% participant engagement, ≥70% treatment appraisal ratings). We hypothesise the ER group will be superior to the Living Better group in the reduction of multiprimary pain outcomes at 1-month post-treatment and opioid outcomes at 1-month and 3 months post-treatment.
    BACKGROUND: The study protocol was approved by the Stanford University School of Medicine Institutional Review Board (IRB 61643). We will publish results in peer-reviewed journals; National Institute of Drug Abuse (funder) and MOBILE Relief participants will receive result summaries.
    BACKGROUND: NCT05152134.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Systematic Review
    心理社会干预对于治疗酒精使用障碍(AUD)至关重要,但是没有关于其有效性的全面证据。因此,本研究旨在确定心理社会干预对青少年和青少年AUD治疗的有效性.
    在本系统综述和荟萃分析中,文章是从EMBASE搜索的,PubMed,Medline,CINAHL,WebofScience,PsycINFO,还有Scopus.此外,文章从灰色文献中检索。已使用Cochrane偏差风险评估来评估文章的质量。
    共纳入12项随机对照试验。综合家庭和CBT,CBT,引导自我改变,基于生态的家庭治疗在减少酒精使用频率方面效果温和。另一方面,综合动机增强疗法和CBT(-0.71[95%CI:-0.97,-0.45])和常见元素治疗方法(4.5[95%CI:6.9,2.2])在减少酒精使用频率和数量方面具有最高的效果,分别。总之,大多数干预措施对不同的饮酒结局没有显著影响.尽管如此,综合干预措施的有效性超过了单一干预措施.心理社会干预对禁欲的影响尚无定论。因此,未来的研究将探索替代方案,新出现的第三波治疗方法。
    PROSPERO,CRD42023435011,https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=435011。
    UNASSIGNED: Psychosocial intervention is imperative for treating alcohol use disorder (AUD), but there is no comprehensive evidence regarding its effectiveness. Therefore, this study aimed to determine the effectiveness of psychosocial interventions in treating AUD amongadolescents and young adults.
    UNASSIGNED: In this systematic review and meta-analysis, articles were searched from EMBASE, PubMed, Medline, CINAHL, Web of Science, PsycINFO, and Scopus. Also, articles were retrieved from gray literature. The quality of articles has been assessed using the Cochrane risk of bias assessment.
    UNASSIGNED: A total of 12 randomized controlled trials were included. Integrated family and CBT, CBT, guided self-change, and ecologically based family therapy had a mild effect in reducing alcohol use frequency. On the other hand, integrated motivational enhancement therapy and CBT (-0.71 [95% CI: -0.97, -0.45]) and common elements treatment approaches (4.5 [95% CI: 6.9, 2.2]) had the highest effect size for reducing alcohol use frequency and amount, respectively. In conclusion, most of the interventions had no significant effect on different drinking outcomes. Nonetheless, the effectiveness of combined interventions surpassed that of the single interventions. The effect of psychosocial interventions on abstinence was inconclusive. Therefore, future studies will explore alternative, newly emerged third-wave therapeutic approaches.
    UNASSIGNED: PROSPERO, CRD42023435011, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=435011.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    背景:英国的心理健康危机率正在上升。社区心理健康模式的出现,如危机解决家庭治疗小组(CRHTT),提供了一条重要的途径,为家中的个人提供强化评估和治疗,包括心理干预。以前的定性文献已经确定了在CRHTT环境中实施心理干预的促进者和障碍;然而,该文献尚未进行综合。为了解决这个差距,进行了系统评价,目的是确定报告的在CRHTT中实施循证心理干预的促进因素和障碍.
    方法:进行系统综述和叙事综合。如果他们检查了在CRHTT环境中基于证据的心理干预措施的实施,则包括研究。研究人群必须是18岁及以上,可能包括在CRHTT工作的医疗保健专业人员,CRHTT的服务用户,或CRHTT服务用户的家人和照顾者。包括任何正式研究方法的研究。搜索了四个数据库(MEDLINE,CINAHLPlus,Embase和PsycINFO),和谷歌学者一起,确定合格的研究。
    结果:确定了六项研究,使用混合的定性和定量方法,主要重点是探索利益相关者对CRHTT内护理实施的看法,涵盖的方面包括但不限于心理护理的实施。文献被认为是中等到高质量的。促进者包括适应心理治疗,优先考虑治疗关系,增加CRHTT员工的心理技能和培训,以及心理知情的CRHTT模型。发现的障碍包括团队内部的医学模型偏见,与CRHTT服务有关的资源约束和元素。
    结论:在这一领域进行进一步的强有力的研究势在必行。我们建议未来的研究以服务评估和随机对照试验(RCT)的形式实施,并使用实施科学的原则来评估和开发CRHTT中心理干预的证据基础。
    BACKGROUND: Mental health crisis rates in the United Kingdom are on the rise. The emergence of community mental health models, such as Crisis Resolution Home Treatment Teams (CRHTTs), offers a vital pathway to provide intensive assessment and treatment to individuals in their homes, including psychological interventions. Previous qualitative literature has identified facilitators and barriers to the implementation of psychological interventions within CRHTT settings; however, a synthesis of this literature has not yet been conducted. To address this gap, a systematic review was undertaken with the aim of identifying the reported facilitators and barriers of implementing evidence-based psychological interventions in CRHTTs.
    METHODS: A systematic review and narrative synthesis were conducted. Studies were included if they examined the implementation of evidence-based psychological interventions in a CRHTT setting. The study population had to be 18 and over and could include healthcare professionals working in CRHTTs, service users of CRHTTs, or family and carers of CRHTT service users. Studies of any formal research methodology were included. Four databases were searched (MEDLINE, CINAHL Plus, Embase and PsycINFO), along with Google Scholar, to identify eligible studies.
    RESULTS: Six studies were identified, using mixed qualitative and quantitative methodologies, with the predominant focus being the exploration of stakeholder perspectives on care implementation within CRHTTs, encompassing aspects including but not restricted to psychological care implementation. The literature was deemed to be of moderate to high quality. Facilitators included adapting psychological therapies, prioritizing the therapeutic relationship, increasing psychological skills and training of CRHTT staff and psychologically informed CRHTT models. The barriers identified included a medical model bias within teams, resource constraints and elements pertaining to CRHTT services.
    CONCLUSIONS: Further robust research in this area is imperative. We recommend that future research be implemented in the form of service evaluations and randomized controlled trials (RCTs) and that the principles of implementation science be used to assess and develop the evidence base for psychological intervention delivery in CRHTTs.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    这项研究旨在比较笑瑜伽和音乐干预对抑郁症的影响,焦虑,老年人的压力被提到Rafsanjan健康中心。
    在这项三臂随机临床试验中,91名60-75岁的抑郁老年参与者,提到Rafsanjan保健中心,随机分为干预组和对照组。该研究遵循平行组设计,分配比例为1:1。笑声瑜伽干预每周进行两次,持续八周,音乐干预包括30分钟的课程,每周两次,共八周。对照组不接受干预(“无治疗”并发对照)。抑郁症状评估(主要结果),焦虑,压力是在基线进行的,干预后,干预后一个月。
    共分析了三组共84名患者的笑声瑜伽干预(n=31),音乐干预(n=25),或对照组(n=28)。重复测量方差分析显示,从测试前到测试后以及一个月的随访,抑郁和焦虑症状显着降低(p<0.001)。干预计划对压力的最大影响是在干预后立即观察到的,但干预计划后一个月压力增加(p=0.125)。
    笑瑜伽和音乐干预被证明对改善抑郁症有效,焦虑,和老年人的压力。然而,笑瑜伽干预显示出优越的效果和老年人更好的接受。
    UNASSIGNED: This study aimed to compare the effects of laughter yoga and music intervention on depression, anxiety, and stress in aged individuals referred to Rafsanjan health centers.
    UNASSIGNED: In this 3-arm randomized clinical trial, 91 depressed aged participants aged 60-75 years, referred to Rafsanjan health centers, were randomly assigned to intervention and control groups. The study followed a parallel group design with an allocation ratio of 1:1. The laughter yoga intervention was conducted twice a week for eight weeks, and music intervention consisted of 30-min sessions twice a week for eight weeks. The control group received no intervention (\'No treatment\' concurrent control). Assessments for depressive symptoms (primary outcome), anxiety, and stress were conducted at baseline, post-intervention, and one month after the intervention.
    UNASSIGNED: A total of 84 patients were analyzed in three groups included the laughter yoga intervention (n = 31), music intervention (n = 25), or control group (n = 28). Repeated measures ANOVA revealed a significant decrease in depressive and anxiety symptoms (p < 0.001) from pre-test to post-test and one-month follow-ups. The greatest impact of the intervention programs on stress was observed immediately after the intervention, but stress increased one month after the intervention programs (p = 0.125).
    UNASSIGNED: Both laughter yoga and music interventions proved effective in improving depression, anxiety, and stress in aged individuals. However, laughter yoga intervention demonstrated a superior effect and better acceptance among elders.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:许多接受门诊物理治疗的人患有肌肉骨骼疼痛,多达三分之一的人使用处方阿片类药物。物理治疗师主导的基于正念的干预措施与循证物理治疗(I-EPT)相结合,以管理慢性肌肉骨骼疼痛和长期阿片类药物治疗患者的影响尚未阐明。该项目评估了进行集群随机试验以测试I-EPT有效性的可行性。
    方法:研究1的目的:完善并手动制定I-EPT治疗方案。我们的方法将使用患者和物理治疗师的半结构化访谈来完善I-EPT培训手册。研究2的目的:评估不同强度的物理治疗师培训计划,以改善I-EPT治疗方案。物理治疗师将被随机分为1:1:1进行高强度训练(HighIT),低IT(LowIT)训练和没有训练武器。培训后,提供I-EPT(LowIT和HighIT组)的能力将使用标准化患者模拟进行评估。研究3目的:评估I-EPT干预跨领域的可行性,有效性,收养,实施,维护实施框架。完善的I-EPT治疗方案将在两个不同的卫生系统中进行测试,其中90名患者由随机物理治疗师管理。研究3的主要终点是疼痛的比例,12周时收集的阿片类药物使用/剂量的生活享受和一般活动量表和时间表跟进。
    背景:这项研究的伦理学批准是从犹他大学获得的,佛罗里达大学和佛罗里达州立大学机构审查委员会。该项目的所有阶段的参与者注册都需要知情同意。完成后,研究数据将按照NIH数据共享政策提供.
    背景:NCT05875207。
    BACKGROUND: Many individuals receiving outpatient physical therapy have musculoskeletal pain and up to one-third use prescription opioids. The impact of physical therapist-led mindfulness-based interventions integrated with evidence-based physical therapy (I-EPT) to manage patients with chronic musculoskeletal pain and long-term opioid treatment has not been elucidated. This project evaluates the feasibility of conducting a cluster randomised trial to test the effectiveness of I-EPT.
    METHODS: Study 1 aim: Refine and manualise the I-EPT treatment protocol. Our approach will use semistructured interviews of patients and physical therapists to refine an I-EPT training manual. Study 2 aim: Evaluate different intensities of physical therapist training programmes for the refined I-EPT treatment protocol. Physical therapists will be randomised 1:1:1 to high-intensity training (HighIT), low-IT (LowIT) training and no training arms. Following training, competency in the provision of I-EPT (LowIT and HighIT groups) will be assessed using standardised patient simulations. Study 3 aim: Evaluate the feasibility of the I-EPT intervention across domains of the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework. The refined I-EPT treatment protocol will be tested in two different health systems with 90 patients managed by the randomised physical therapists. The coprimary endpoints for study 3 are the proportions of the Pain, Enjoyment of Life and General Activity Scale and the Timeline Followback for opioid use/dose collected at 12 weeks.
    BACKGROUND: Ethics approval for the study was obtained from the University of Utah, University of Florida and Florida State University Institutional Review Boards. Informed consent is required for participant enrolment in all phases of this project. On completion, study data will be made available in compliance with NIH data sharing policies.
    BACKGROUND: NCT05875207.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:患有癌症的青少年和年轻人(AYAs)处于不良心理社会结果的风险中。随着互联网和数字技术的发展,和移动健康(mHealth)心理社会干预有可能克服护理障碍。
    目的:本先导随机对照试验(RCT)旨在建立可行性,可接受性,以及在压力管理干预(mPRISM)中促进弹性的全自动移动应用程序版本的初步功效。促进压力管理中的弹性是与AYAs合作开发的基于证据的干预措施,基于压力和应对理论,韧性理论,和基于证据的应对策略。我们假设mPRISM是可行的,可接受,和适当的。
    方法:这是并行的,双臂,具有等待列表控制设计的单站点飞行员RCT。该研究将从一家诊所招募80名患有癌症的AYAs。合资格的AYAs年龄在12至25岁之间,在新的癌症诊断后的12个月内,接受化疗或放疗,说话,阅读,或者用英语写,并且在认知上能够参与研究程序。临床研究协调员的招募将通过电话远程进行,视频,或文本。参与者将被随机分配到心理社会常规护理(UC)单独或UC加mPRISM,为期8周的干预期。并将保持对研究状况的了解。注册参与者将在随机化之前完成基线调查,8周,和3个月的随访。使用waitlist设计,UC部门将在完成3个月的跟踪调查后收到mPRISM。UC组的患者将在治疗后立即和3个月后完成2个额外的测量点。感兴趣的主要结果是可行性,定义为≥60%注册和≥70%保留(即,完成研究的参与者的百分比),和“可行性”,可接受性,和适当性“定义为3项简短验证的实施结果措施的截止分数≥4/5(实施措施的可行性,干预措施的可接受性[AIM],干预适当性措施[IAM])。我们将对实施措施应用机顶盒评分。感兴趣的探索性结果包括患者报告的健康相关生活质量,弹性,苦恼,焦虑,抑郁症,疼痛,和睡眠。我们将进行意向治疗分析,通过协变量调整回归模型比较mPRISM臂与对照臂的结果。我们将使用描述性统计来总结各个数字使用指标。
    结果:自2023年9月以来,我们已经招募了20名参与者,并且正在进行招募。
    结论:尽管我们之前的工作表明,患有癌症的AYAs对mHealth心理社会干预措施感兴趣,此类干预措施尚未在AYA肿瘤患者中得到充分评估或实施.mPRISM可以作为潜在的mHealth干预措施来填补这一空白。在这项研究中,我们将测试可行性,可接受性,和mPRISM的初步疗效。这项工作将为未来更大规模的RCT提供有效的结果。
    背景:ClinicalTrials.govNCT05842902;https://clinicaltrials.gov/study/NCT05842902。
    DERR1-10.2196/57950。
    BACKGROUND: Adolescents and young adults (AYAs) with cancer are at risk of poor psychosocial outcomes. AYAs grew up with the internet and digital technology, and mobile Health (mHealth) psychosocial interventions have the potential to overcome care access barriers.
    OBJECTIVE: This pilot randomized controlled trial (RCT) aimed to establish the feasibility, acceptability, and preliminary efficacy of a fully automated mobile app version of the Promoting Resilience in Stress Management intervention (mPRISM). Promoting Resilience in Stress Management is an evidence-based intervention developed in collaboration with AYAs, based on stress and coping theory, resilience theory, and evidence-based coping strategies. We hypothesized that mPRISM would be feasible, acceptable, and appropriate.
    METHODS: This is a parallel, 2-arm, single-site pilot RCT with a waitlist control design. The study will recruit 80 AYAs with cancer from a clinic. Eligible AYAs are aged 12 to 25 years, within 12 months of a new cancer diagnosis, receiving chemotherapy or radiation therapy, speak, read, or write in English, and are cognitively able to participate in study procedures. Recruitment by clinical research coordinators will occur remotely by phone, video, or text. Participants will be randomized to psychosocial usual care (UC) alone or UC plus mPRISM for an 8-week intervention period, and will remain unblinded to study condition. Enrolled participants will complete surveys at baseline before randomization, 8 weeks, and 3-month follow-up. Using a waitlist design, the UC arm will receive mPRISM upon completion of 3-month follow-up surveys. Those in the UC arm will complete 2 additional measurement points at immediate posttreatment and 3 months later. The primary outcomes of interest are feasibility, defined as ≥60% enrollment and ≥70% retention (ie, percentage of participants who completed the study), and \"feasibility, acceptability, and appropriateness\" as defined by cut-off scores ≥4/5 on 3 brief validated implementation outcome measures (feasibility of implementation measure, acceptability of intervention measure [AIM], intervention appropriateness measure [IAM]). We will apply top-box scoring for the implementation measures. Exploratory outcomes of interest include patient-reported health-related quality of life, resilience, distress, anxiety, depression, pain, and sleep. We will conduct an intention-to-treat analysis to compare the outcomes of the mPRISM arm versus the control arm with covariate-adjusted regression models. We will summarize individual digital usage metrics using descriptive statistics.
    RESULTS: Since September 2023, we have enrolled 20 participants and recruitment is ongoing.
    CONCLUSIONS: Although our previous work suggests AYAs with cancer are interested in mHealth psychosocial interventions, such interventions have not yet been sufficiently evaluated or implemented among AYA oncology patients. mPRISM may serve as a potential mHealth intervention to fill this gap. In this study, we will test the feasibility, acceptability, and preliminary efficacy of mPRISM. This work will inform future larger-scale RCTs powered for efficacy outcomes.
    BACKGROUND: ClinicalTrials.gov NCT05842902; https://clinicaltrials.gov/study/NCT05842902.
    UNASSIGNED: DERR1-10.2196/57950.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号