Group intervention

团体干预
  • 文章类型: Journal Article
    本研究旨在提供关于共享阅读或写作活动影响的综合知识,也就是说,涉及基于个人发展的动态关系的娱乐职业,55岁及以上的成年人。使用范围界定研究框架,搜索了六个数据库,其中包含25个相关的论文关键词,theses,以及2001-2023年发表的科学报告。基于人类发展模式——残疾人创造过程,对20篇文献的内容分析显示,共享阅读或写作活动大多有利于老年人的行为能力,如积极的情感,他们的智力能力,例如发展新的生活观点,他们的人际关系,和社会支持。负实例,比如挫折,在活动开始时经常提到,但随着时间的推移而减少。这些结果表明,共享阅读或写作活动对健康老龄化的重要性,以及更好地支持这些活动以实现更具包容性和爱心的老龄化社会的必要性。
    This study aimed to provide integrated knowledge on the influence of shared reading or writing activities, that is, recreational occupations involving dynamic relationships based on personal development, on adults aged 55 and older. Using a scoping study framework, six databases were searched with 25 relevant keywords for papers, theses, and scientific reports published in 2001-2023. Based on the Human Development Model-Disability Creation Process, the content analysis of 20 documents showed that shared reading or writing activities mostly benefited aging adults\' behavioral capabilities like positive affect, their intellectual capacities, such as developing new perspectives on life, their interpersonal relationships, and social support. Negative instances, such as frustration, were often mentioned at the beginning of the activities but decreased over time. These results suggest the importance of shared reading or writing activities for healthy aging and the necessity to better support these activities for more inclusive and caring aging societies.
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  • 文章类型: Journal Article
    饮食行为失调,包括亚阈值和临床暴食症(BED)和神经性贪食症(BN),在普通人群中正在增加,从而对一个人的健康和福祉产生负面影响。尽管这些结果很严重,患有BED和BN的人通常会延迟接受诊断或治疗,通常是由于难以获得护理。因此,需要对饮食症状进行基于证据和可持续的干预.本研究旨在评估基于BED和BN的辩证行为疗法(DBT)的基于网络的10次多学科小组干预的有效性,旨在减少饮食行为失调患者的心理困扰和与暴饮暴食相关的症状,并包括一次营养治疗教育。共有65名参与者(84.6%F;年龄M=38.5±13.2;实验组,N=43;照常治疗组,TAU,N=22)参加了这项研究。结果显示,在每周九次会议之后,与照常治疗组相比,实验组与暴饮暴食相关的症状学和一般精神病理学显着降低,在社会环境中自尊和饮食自我效能感增加(T0vs.T1).在暴饮暴食症状方面,从干预结束(T2)一个月后,实验组的改善显着维持,一般精神病理学,在社会环境中吃自我效能感。这项研究支持了简短的基于网络的多学科小组干预在减少饮食症状和心理困扰以及增强饮食行为失调的人群中的自尊和饮食自我效能感方面的有效性。简短的基于网络的干预措施可以代表可访问和可持续的资源,以解决公共临床环境中与暴食相关的症状。
    Dysregulated eating behaviors, comprising subthreshold and clinical binge-eating disorder (BED) and bulimia nervosa (BN), are increasing among the general population, with a consequent negative impact on one\'s health and well-being. Despite the severity of these outcomes, people with BED and BN often face a delay in receiving a diagnosis or treatment, often due to difficulties in accessing care. Hence, evidence-based and sustainable interventions for eating symptomatology are needed. The present study aims to assess the effectiveness of a web-based 10-session multidisciplinary group intervention based on Dialectical Behavior Therapy (DBT) for BED and BN, aimed at reducing psychological distress and binge-eating-related symptomatology in a sample of patients with dysregulated eating behaviors and including one session of nutritional therapeutic education. A total of 65 participants (84.6% F; age M = 38.5 ± 13.2; experimental group, N = 43; treatment-as-usual group, TAU, N = 22) took part in the study. The results show, after the 9 weekly sessions, a significant reduction in binge-eating-related symptomatology and general psychopathology and an increased self-esteem and eating self-efficacy in social contexts in the experimental group compared to the treatment-as-usual group (T0 vs. T1). Improvements in the experimental group were significantly maintained after one month from the end of the intervention (T2) in terms of binge-eating symptoms, general psychopathology, and eating self-efficacy in social contexts. This study supports the effectiveness of a brief web-based multidisciplinary group intervention in reducing eating symptomatology and psychological distress and enhancing self-esteem and eating self-efficacy in a group of people with dysregulated eating behaviors. Brief web-based interventions could represent an accessible and sustainable resource to address binge-eating-related symptomatology in public clinical settings.
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  • 文章类型: Journal Article
    在新兴成年人中,高度需要改善心理健康的途径,尤其是在大学校园里。基于正念的干预(MBI)是减少心理健康症状的有希望的途径,但是与MBI相关的初始不适可能会导致症状在下降之前波动,这是每天接触正念的障碍。一致的正念练习是形成与MBI相关的习惯的关键,在家里与正念互动,包括干预会议之间,是心理健康结果的重要预测指标。研究表明,心理健康症状可能成为他们自己治疗的障碍。因此,重要的是要了解心理健康症状水平如何影响对治疗方案的依从性.为了提高对治疗和参与正念的症状特异性障碍的理解,本研究从被招募参加为期6周的正念干预的62名成年人的样本中收集了有关正念参与和心理健康症状的每日日记调查.我们探索了心理健康症状作为平均水平上MBI参与度的预测因子,以及症状的人内变异性是否通过混合效应关联预测了同一天或时滞的参与度变化。使用异构位置尺度模型,我们进一步探讨了精神健康症状或正念参与中的反常主义是否能预测另一种,以及正念干预的结果在受试者中是否一致.结果表明,症状和参与之间存在双向和时滞的关联,这表明与正念和心理健康症状之间存在微妙的时间和互惠关系。每天参与正念的人内升高与心理健康的同时改善有关,但心理健康症状的预期增加。我们还发现,更高的参与度(超过个人平均水平)与整个样本中心理健康的改善并不一致,而是与结果的更大异质性相关。我们还发现心理健康症状的增加(超过个人平均水平),以及较高的心理健康症状平均水平,两者都与正念治疗方案的参与度较低有关。
    There is a high need for accessible avenues for improving mental health among emerging adults, particularly on college campuses. Mindfulness-based intervention (MBI) is a promising avenue for reducing mental health symptoms, but initial discomforts associated with MBI may cause symptoms to fluctuate before decreasing, which presents a barrier to engagement with mindfulness on a daily basis. Consistent mindfulness practice is key for forming habits related to MBI, and engagement with mindfulness at home, including between intervention sessions, is an important predictor of mental health outcomes. Research suggests that mental health symptoms may serve as barriers to their own treatment. Thus, it is important to understand how mental health symptom levels impact adherence to treatment protocols. To improve understanding of symptom-specific barriers to treatment and engagement with mindfulness, the present study collected daily diary surveys about engagement with mindfulness and mental health symptoms from a sample of 62 adults recruited to participate in a six-week mindfulness intervention. We explored mental health symptoms as a predictor of engagement with MBI at the mean level and whether within-person variability in symptoms predicted same-day or time-lagged changes in engagement via mixed-effects associations. Using heterogeneous location scale models, we further explored whether erraticism in either mental health symptoms or engagement with mindfulness predicted the other and if outcomes of the mindfulness intervention were homogeneous among subjects. Results showed that bi-directional and time-lagged associations exist between symptoms and engagement, indicating that there is a nuanced temporal and reciprocal relationship between engagement with mindfulness and mental health symptoms. Daily within-person elevations in engagement with mindfulness were associated with concurrent improvements in mental health but prospective increases in mental health symptoms. We also found that higher engagement (over personal averages) was not consistently associated with improvements in mental health across the sample but was instead associated with greater heterogeneity in outcomes. We also found that increases in mental health symptoms (over personal averages), as well as higher average levels of mental health symptoms, were both associated with lower levels of engagement in the mindfulness treatment protocol.
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  • 文章类型: Journal Article
    在苛刻的工作生活中,确定个人如何在工作中茁壮成长是很重要的。在先前的研究中,我们调查了感恩干预计划是否可以增加心理健康,订婚,工作满意度,和心理资本显示出有希望的结果。
    本研究旨在介绍与工作场所感恩有关的经理指导小组干预计划的开发,并研究该计划对相同变量的影响。
    干预包括五个小组的员工之间的感恩对话,由他们的一线经理监督。参与者被分配到干预组或对照组。在干预前后进行评估,并在干预后6个月进行随访。进行了定量和定性分析。两组都完成了测量积极心理资本(PCQ)的工具,工作参与(UWES),心理健康(PGWB-S),和工作满意度(aJDI)。干预后对所有经理进行了访谈。
    与对照组相比,发现感恩对话干预显着增强了心理健康,订婚,和工作满意度。结果得到了与管理人员的访谈的支持。
    我们的研究结果表明,工作中的感恩对话可能是改善员工福祉的有效途径。提出了如何进一步改善这种感恩干预效果的建议。
    UNASSIGNED: In a demanding working life, it is important to determine how individuals can thrive at work. In a previous study we investigated whether a program of gratitude interventions can increase psychological wellbeing, engagement, job satisfaction, and psychological capital showing promising results.
    UNASSIGNED: of the present study was to present the development of a manager coached group intervention program related to gratitude at workplaces and to investigate the effects of such a program on the same variables.
    UNASSIGNED: The intervention included five group sessions of gratitude dialogue between employees, supervised by their first line managers. Participants were assigned to an intervention or control group. Assessments were made before and after the intervention program and followed-up at 6 months post-intervention. Both quantitative and qualitative analyses were performed. Both groups completed instruments measuring positive psychological capital (PCQ), work engagement (UWES), psychological wellbeing (PGWB-S), and job satisfaction (aJDI). All managers were interviewed after the intervention.
    UNASSIGNED: Compared with the control group the gratitude dialogue intervention was found to significantly enhance psychological wellbeing, engagement, and job satisfaction. The results were supported by the interviews with managers.
    UNASSIGNED: our results suggest that gratitude dialogues at work may be an effective way of improving employee wellbeing. Suggestions on how to improve the results from this kind of gratitude intervention further are presented.
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  • 文章类型: Journal Article
    蛛网膜下腔出血(SAH)幸存下来的人经常面临持久的健康挑战,包括身体残疾。疲劳,认知障碍,心理障碍,降低了生活质量。虽然团体干预在解决慢性病中的类似问题方面取得了积极成果,特别涉及SAH的证据仍然很少。这项服务评估旨在探索SAH幸存者参加多学科团体支持计划的经验,以解决以前文献中确定的未满足的需求。最终目的是完善该计划的未来迭代并提高SAH后的护理质量。
    对参加该计划的12个人进行了半结构化访谈。对所得数据进行了主题分析。
    分析中出现了四个总体主题:(1)SAH后获得支持的障碍,(2)作为复苏推动者的因素,(3)分享生活经验以互相支持,(4)在导航组格式时感觉连接。
    缺乏沟通,恐惧,孤独,认知障碍可以成为参与支持的障碍,在接受和调整的同时,整体多学科投入,和心理支持可能代表成功的恢复推动者。讨论了对该计划未来迭代以及临床康复和服务开发的影响。
    基于多学科小组的支持计划可能有助于蛛网膜下腔出血(SAH)后的康复。缺乏沟通等因素,恐惧,孤独,认知障碍可能成为参与的障碍,在接受和调整的同时,全面的多学科团队投入,和心理支持可以使恢复。服务部门可能希望监测沟通的有效性和频率,同时确保SAH患者出院时明确的支持途径和既定的转诊途径。为参与者提供书面材料,以便在每次会议期间使用,并允许更多的时间彼此联系,这可能有助于在小组会议期间解决认知困难。
    UNASSIGNED: People who survive a subarachnoid haemorrhage (SAH) often face enduring health challenges including physical disability, fatigue, cognitive impairments, psychological difficulties, and reduced quality of life. While group interventions have shown positive results in addressing similar issues in chronic conditions, the evidence involving SAH specifically is still sparse. This service evaluation aimed to explore SAH survivors\' experiences of attending a multidisciplinary group-based support programme tailored to address unmet needs identified in previous literature, with the ultimate aim to refine future iterations of the programme and improve quality of care post-SAH.
    UNASSIGNED: Semi-structured interviews were carried out with 12 individuals who attended the programme. The resulting data were analysed thematically.
    UNASSIGNED: Four overarching themes emerged from the analysis: (1) Barriers to accessing support after a SAH, (2) Factors acting as enablers of recovery, (3) Sharing lived experience to support one another, (4) Feeling connected while navigating a group format.
    UNASSIGNED: Lack of communication, fear, loneliness, and cognitive impairments can act as barriers to engagement with support, while acceptance and adjustment, holistic multidisciplinary input, and psychological support may represent successful enablers of recovery. Implications for future iterations of the programme as well as clinical rehabilitation and service development are discussed.
    A multidisciplinary group-based support programme may help rehabilitation following a subarachnoid haemorrhage (SAH).Factors such as lack of communication, fear, loneliness, and cognitive impairments may act as barriers to engagement, while acceptance and adjustment, holistic multidisciplinary team input, and psychological support may enable recovery.Services may wish to monitor the effectiveness and frequency of their communication while making sure a clear pathway of support and established referral routes are in place when SAH patients are discharged from hospital.Providing participants with written materials to use during each session as well as allowing for more time to connect with one another other may help with cognitive difficulties during group sessions.
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  • 文章类型: Journal Article
    背景:患有各种罕见或孤儿疾病(ROD)的患者会遇到常见的心理社会困难。这些需求来自多种因素的结合,例如患者种类繁多,资源稀少,以及对身体健康需求的集中努力,提高了患者的预期寿命和质量。因此,在考虑患者的心理社会需求方面的差距正在扩大,例如应对身体限制的影响,减少社会孤立和痛苦。为了弥补这一差距,我们开发了,试点测试和评估的可接受性,可行性,实施,以及Connect-ROD的短期影响,在线团体干预,以支持成年患者的ROD(AP-ROD),旨在改善应对机制,加强控制感,并支持AP-ROD的个人目标。一项由深入预测试组成的定性研究,测试后访谈和标准化问卷,对两个连续干预组的14名参与者进行了研究。
    结果:Connect-ROD干预在接受和承诺疗法以及社区心理学方法中有着强烈的锚定。试点测试使我们能够改进初始结构,并制作在线交付的手动10周计划,由2小时的会议组成,包括正式活动,交流和作业。评估显示令人满意的可接受性和可及性,主持人的合规交付,以及对个人目标的短期影响,控制感,应对机制,症状管理,接受与疾病相关的情绪,苦恼,自我效能感,社会支持和联系。该计划未显示对整体生活质量的短期影响。
    结论:建议对Connect-ROD进行更大规模的评估。似乎有希望支持各种AP-ROD,他们生活在疾病的复杂心理社会后果中。
    BACKGROUND: Patients living with various rare or orphan diseases (ROD) experience common psychosocial difficulties. Those need emerge from a combination of factors, such as the large variety of patients and the rarity of resources, as well as concentrated efforts on physical health needs that yielded increases in life expectancy and quality in patients. A gap is therefore rising in the consideration of psychosocial needs of patients, such as coping with the impacts of physical limitations, reducing social isolation and distress. To contribute to address this gap, we developed, pilot-tested and evaluated the acceptability, feasibility, implementation, and short-term effects of Connect-ROD, an online group intervention to support adult patients with a ROD (AP-ROD), which aims to improve coping mechanisms, reinforce sense of control, and support personal goals of AP-ROD. A qualitative study comprising of in-depth pretests, post-test interviews and standardized questionnaires, was conducted with 14 participants in two consecutive intervention groups.
    RESULTS: The Connect-ROD intervention is strongly anchored in acceptance and commitment therapy as well as community psychology approaches. A pilot test allowed us to improve on the initial structure and to produce a manualized 10-week program delivered online, made up of 2-h sessions comprising formal activities, exchanges and homework. The evaluation showed satisfactory acceptability and accessibility, compliant delivery by facilitators, and promising short-term effects on personal objectives, sense of control, coping mechanisms, symptom management, acceptance of the emotions associated with the disease, distress, self-efficacy, social support and connectedness. The program did not show short-term effects on overall quality of life.
    CONCLUSIONS: It is recommended that Connect-ROD is evaluated on a larger scale. It seems promising to support various AP-ROD who live with the complex psychosocial consequences of their disease.
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  • 文章类型: Journal Article
    背景:患有MS(pwMS)的人通常会出现一系列隐藏症状,包括认知障碍,焦虑和抑郁,疲劳,疼痛,和感官困难。这些“看不见的”症状会显著影响健康,关系,就业和生活目标。我们开发了一种新颖的定制在线小组神经心理干预措施,将心理教育和认知康复与接受和承诺疗法(ACT)知情方法相结合,用于急性三级医院的pwMS。MS(NIMIS-MS)中的“管理隐形症状的神经心理学干预”包括6个疗程,每个都有心理教育和行为部分。内容包括围绕管理认知困难的心理教育,疲劳,疼痛,睡眠和其他不愉快的感觉在MS的一般方法的理解,监测,识别模式和潜在的触发因素。介绍了具体的认知康复和疲劳管理策略。ACT知情组件专注于心理灵活性的“Triflex”的三个核心ACT领域(Harris,2019):在场,打开,做重要的事。
    方法:118pwMS参加了NIMIS-MS组干预,在18个月的时间内,在6周的阻滞中进行了14次。评估有效性和可接受性,参与者完成了抑郁和焦虑(HADS)的测量,功能损害(WSAS),价值-进度(VQ)和价值-障碍(VQ),NIMIs-MS组干预前后接受MS(MSAS)。在最后一次会议后的焦点小组期间以及通过在线反馈问卷获得定性反馈结果:事后分析显示,在完成NIMIS-MS组之后,抑郁和焦虑症状显着降低,对MS的接受度显着提高。定性反馈显示,参与者报告说,他们觉得更有能力在完成小组后管理MS的“隐形”症状,并受益于使用基于ACT的策略和技术。与会者高度重视NIMIS-MS小组期间发展起来的同行支持。在线格式被认为比面对面的团体更容易获得,由于对旅行时间的关注较少,成本,疲劳,舒适和感染。
    结论:评估表明,我们的新型NIMIS-MS组是可以接受的,为患有MS的个体提供神经心理学干预的有益和可行的方法。
    BACKGROUND: People with MS (pwMS) commonly experience a range of hidden symptoms, including cognitive impairment, anxiety and depression, fatigue, pain, and sensory difficulties. These \"invisible\" symptoms can significantly impact wellbeing, relationships, employment and life goals. We developed a novel bespoke online group neuropsychological intervention combining psychoeducation and cognitive rehabilitation with an Acceptance and Commitment Therapy (ACT)-informed approach for pwMS in an acute tertiary hospital. This \'Neuropsychological Intervention for Managing Invisible Symptoms\' in MS (NIMIS-MS) consisted of 6 sessions, each with a psychoeducation and ACT component. The content included psychoeducation around managing cognitive difficulties, fatigue, pain, sleep and other unpleasant sensations in MS with the general approach of understanding, monitoring, and recognising patterns and potential triggers. Specific cognitive rehabilitation and fatigue management strategies were introduced. The ACT-informed component focussed on three core ACT areas of the \'Triflex\' of psychological flexibility (Harris, 2019): Being Present, Opening Up, and Doing What Matters.
    METHODS: 118 pwMS attended the NIMIS-MS group intervention which was delivered 14 times in six-week blocks over an 18-month period. To evaluate the effectiveness and acceptability, participants completed measures of depression and anxiety (HADS), functional impairment (WSAS), Values- Progress (VQ) and Values- Obstruction (VQ), and Acceptance of MS (MSAS) pre and post NIMIs-MS group intervention. Qualitative feedback was obtained during focus groups after the final session and via online feedback questionnaires RESULTS: Pre-post analysis showed that symptoms of depression and anxiety were significantly lower and acceptance of MS was significantly higher following completion of the NIMIS-MS group. Qualitative feedback showed that participants reported that they felt more equipped to manage the \"invisible\" symptoms of MS following completion of the group, and benefited from using ACT-based strategies and techniques. Participants highly valued the peer support that evolved during the NIMIS-MS groups. The online format was considered more accessible than in-person groups, due to less concerns of travel time, cost, fatigue, and comfort and infection.
    CONCLUSIONS: Evaluation suggests that our novel NIMIS-MS groups is an acceptable, beneficial and feasible approach for providing neuropsychological interventions to individuals with MS.
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  • 文章类型: Clinical Trial Protocol
    背景:在儿童福利机构中成长的儿童和青少年经常遭受创伤事件和心理社会压力,并表现出精神障碍的发生率升高。然而,缺乏经验支持的治疗方法,为患有创伤相关精神障碍(如创伤后应激障碍(PTSD))的儿童提供充分的精神保健。抑郁症,和焦虑。学校创伤的认知行为干预(CBITS)是一种评估的以创伤为重点的认知行为团体干预,这已被证明可以有效减轻创伤后应激障碍的症状,抑郁症,以及受创伤儿童在群体环境中的焦虑。该试验将评估CBITS干预作为外展治疗的有效性,与德国心理健康和儿童福利系统中的常规治疗(TAU)相比。
    方法:在一项涉及N=90儿童和青少年的随机对照试验(RCT)中,我们将比较CBITS与TAU+。参与者在8至16岁之间,报告至少一个创伤事件和中度创伤后应激症状(PTSS),将使用CATS-2严重程度分层区组随机化在其儿童福利机构中随机分配到任一条件。评估将在基线进行,以及基线后4个月和10个月。主要结果是4个月后PTSS的严重程度。次要结果是抑郁,焦虑,烦躁/愤怒,生活质量,和全球运作水平。
    结论:我们的试验结果将为受创伤儿童的护理提供有效治疗方案的证据。这代表了一个研究不足的人群,获得精神保健的机会有限。此外,它可以作为为护理中的儿童实施以创伤为重点的外展小组治疗的蓝图,并增加获得适当治疗的机会。
    背景:临床试验.govNCT06038357D.2023年9月13日。
    BACKGROUND: Children and adolescents growing up in child welfare institutions have been frequently exposed to traumatic events and psychosocial stress and show elevated rates of mental disorders. Yet, there is a lack of empirically supported treatments to provide adequate mental health care for children in care suffering from trauma-related mental disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety. The Cognitive Behavioral Intervention for Trauma in Schools (CBITS) is an evaluated trauma-focused cognitive-behavioral group intervention, which has proven to be effective in reducing symptoms of PTSD, depression, and anxiety for traumatized children in group settings. The trial will evaluate the effectiveness of the CBITS intervention as an outreach treatment compared with an enhanced treatment-as-usual condition (TAU +) within the German mental health and child welfare system.
    METHODS: In a randomized controlled trial (RCT) involving N = 90 children and adolescents, we will compare CBITS with TAU + . Participants between 8 and 16 years, reporting at least one traumatic event and moderate posttraumatic stress symptoms (PTSS), will be randomized within their child welfare institution to either one of the conditions using a CATS-2 severity-stratified block randomization. Assessments will take place at baseline, as well as 4 months and 10 months after baseline. The primary outcome is the severity of PTSS after 4 months. Secondary outcomes are depression, anxiety, irritability/anger, quality of life, and global functioning level.
    CONCLUSIONS: The results of our trial will provide evidence regarding effective treatment options for traumatized children in care, which represent an understudied population with limited access to mental health care. Additionally, it could serve as a blueprint for implementing trauma-focused outreach group treatments for children in care and increase the accessibility to appropriate treatment.
    BACKGROUND: Clinical Trials.gov NCT06038357 D. September 13, 2023.
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  • 文章类型: Journal Article
    包括常规的客户反馈可以提高儿童心理健康干预的有效性,尤其是按预期实施时。执行率,或剂量,在一些研究中,这种反馈干预措施的结果被证明是温和的。客户反馈的实现和使用的变化也可能导致反馈文献中观察到的混合结果。本研究在指定的小组干预中使用新型测量反馈系统(MFS)评估客户反馈的剂量反应关联。主要目的是确定MFS实施率是否可以预测学龄儿童焦虑和抑郁症状的减轻。次要目的是评估MFS实施率是否影响儿童对团体干预的满意度或辍学率。数据是通过一项随机析因研究(clinicaltrials.govNCT04263558)在挪威的58所小学收集的。8至12岁的儿童(N=701)参加了基于小组的活动,针对焦虑或抑郁症状升高的综合诊断干预。一半的儿童群体也接受了使用MittEchoMFS的反馈干预。组长(N=83),当地招募,促进干预。使用实施指数测量MFS剂量,它将儿童和提供者(组长)对MFS的使用结合到一个单剂量变量中。结果显示,MFS剂量对抑郁或焦虑评分的变化没有显著的额外影响,关于用户对干预的满意度或干预退出。Thediscussionaddressespotentialreasonsforthesenon-significantfindingsandimplicationsforMFSimplicationsinpreventive,学校环境中基于小组的干预措施。
    Including routine client feedback can increase the effectiveness of mental health interventions for children, especially when implemented as intended. Rate of implementation, or dose, of such feedback interventions has been shown to moderate results in some studies. Variation in implementation and use of client feedback may also contribute to the mixed results observed within the feedback literature. This study evaluates dose-response associations of client feedback using a novel Measurement Feedback System (MFS) within an indicated group intervention. The primary aim was to determine whether the rate of MFS implementation predicts symptom reduction in anxiety and depression among school-aged children. The secondary aim was to assess whether the rate of MFS implementation influences children\'s satisfaction with the group intervention or their dropout rates. Data were collected via a randomized factorial study (clinicaltrials.gov NCT04263558) across 58 primary schools in Norway. Children aged 8 to 12 years (N = 701) participated in a group-based, transdiagnostic intervention targeting elevated symptoms of anxiety or depression. Half of the child groups also received the feedback intervention using the MittEcho MFS. Group leaders (N = 83), recruited locally, facilitated the interventions. The MFS dose was measured using the Implementation Index, which combines the use of MFS by both children and providers (group leaders) into a single dose variable. Results showed no significant additional effect of dose of MFS on change in depression or anxiety scores, on user satisfaction with the intervention or on intervention dropout. The discussion addresses potential reasons for these non-significant findings and implications for MFS implementation in preventive, group-based interventions in school settings.
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  • 文章类型: Journal Article
    背景:南非青少年的创伤暴露率和随之而来的创伤后应激障碍很重要。睡眠障碍是处理PTSD的人所面临的最常报告的困难之一。本研究检查了南非青少年组睡眠干预对PTSD症状严重程度和睡眠障碍的可行性和初步疗效。方法:将61名患有PTSD诊断和睡眠障碍的青少年随机分配(1:1)到一个人和四个睡眠干预组(SAASI)或对照组。参与者完成了DSM5(CPSS-5)和匹兹堡睡眠质量指数(PSQI)的儿童PTSD症状量表,以及其他睡眠和精神病学指标。该试验已在泛非试验登记处登记(PACTR202208559723690)。结果:随着时间的推移,两组的PSQI评分均有显着但相似的下降,表明没有总体干预效果(Wald检验=-2.18,p=0.029),平均斜率=-0.2(95%CI:-0.37至-0.02)(p=.583)。在CPSS-5上,组间的相互作用也不显著(p=0.291)。尽管有这样的发现,CPSS-SR-5分数的平均差异随着时间的推移而增加,治疗后组间差异为-9.10(95CI:-18.00至-0.21),p=.045,1个月随访对比-11.22(95CI:-22.43至-0.03),p=.049表明干预组的PTSD症状严重程度比对照组降低更多。干预组(n=10;32%)和对照组(n=8;26.7%)的辍学率均高于预期。辍学主要是与学校承诺或旅行相关的。结论:早期发现表明,在接受集体睡眠干预(SAASI)的患有睡眠障碍和PTSD的青少年中,睡眠质量和PTSD症状严重程度有双重改善的趋势。指出了在具有详细保留计划的正确供电的RCT中进行进一步调查。
    在资源匮乏的南非环境中,对患有PTSD和睡眠障碍的青少年进行为期四周的集体睡眠干预似乎是可行的。在干预实施中利用护士和辅导员等专业较少的心理健康资源是可行且有效的。初步结果是有希望的,并支持进一步研究以建立干预措施的功效。
    Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = -2.18, p = .029), mean slope = -0.2 (95% CI: -0.37 to -0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: -22.43 to -0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.
    A four-week group sleep intervention seems feasible in adolescents with PTSD and sleep disturbances in a low-resource South African setting.Utilising less specialised mental health resources such as nurses and counsellors in intervention delivery was feasible and effective.Preliminary results are promising and support further research to establish the efficacy of the intervention.
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