背景:通过代理的健康焦虑(HA)被描述为父母对他们的孩子病情严重的强迫性担忧,尽管这没有得到医学证实。通过代理对HA进行的研究表明,这对父母来说是非常痛苦的,并且孩子可能有发展适应不良症状应对策略的风险。不存在针对该组的靶向治疗。我们开发了PROXY,通过代理为患有HA的父母提供为期8周的心理互联网治疗。PROXY的治疗成分由认知行为疗法以及接受和承诺疗法提供信息,它是由代理和临床专家与经历HA的父母合作开发的。
目的:本文描述了一项研究方案,该方案使用单案例实验设计(SCED)调查PROXY对父母对子女健康的担忧的潜在影响。
方法:将包括通过代理临床评估为经历HA的五位父母。将进行重复的随机SCED研究,其中每个参与者将被随机分配以在7至26天的基线期后接受治疗(A期)。所有参与者的治疗期持续时间为8周(B期),随后是持续14至33天的随访阶段(C阶段),确保所有参与者在研究中停留96天。在整个研究过程中,参与者将通过SMS短信报告每日焦虑水平。他们还将回答自我报告问卷,包括通过代理人和自己的HA对HA的问题,研究期间的4次。数据将提交给结构化视觉分析,以检查焦虑水平,焦虑的变异性,趋势,各阶段之间数据点的重叠,当影响发生时,以及参与者之间数据模式的一致性。此外,将对每位参与者进行随机化测试,以检验PROXY对参与者焦虑无影响的零假设.
结果:父母招募工作于2022年6月开始。截至2023年3月2日,共有4名父母被纳入研究。数据收集预计将于2023年4月停止。
结论:据我们所知,该方案描述了唯一通过代理治疗HA的研究.由于这种情况的流行程度仍然未知,之所以选择SCED,是因为该方法允许纳入非常少的参与者,同时仍提供有关效果和治疗过程的信息.尽管参与者很少,但使用重复的随机阶段设计进行研究可以进行方法学上的合理测试。结果将告知研究人员个别治疗过程和效果,这可能会指导未来对可能的变化机制的研究,如何完善治疗内容的想法,以及将来如何为患者提供治疗。
背景:ClinicalTrials.govNCT04830605;https://clinicaltrials.gov/study/NCT04830605。
■DERR1-10.2196/46927。
BACKGROUND: Health anxiety (HA) by proxy is described as parents\' obsessive worries that their child is severely ill although this is not medically confirmed. Research on HA by proxy suggests that it is highly distressing for the parent and that the child may be at risk of developing maladaptive symptom coping strategies. No targeted treatment for this group exists. We developed PROXY, an 8-week psychological internet-delivered treatment for parents with HA by proxy. The treatment components of PROXY are informed by cognitive behavioral therapy as well as acceptance and commitment therapy, and it was developed in collaboration with parents experiencing HA by proxy and clinical experts.
OBJECTIVE: This paper describes the protocol for a study investigating the potential effects of PROXY on parents\' worries about their children\'s health using a single-case experimental design (SCED).
METHODS: Five parents clinically evaluated as experiencing HA by proxy will be included. A replicated randomized SCED study will be conducted in which each participant will be randomized to receive treatment after a baseline period of between 7 and 26 days (phase A). The treatment phase duration is 8 weeks for all participants (phase B), followed by a follow-up phase lasting between 14 and 33 days (phase C), ensuring that all participants remain in the study for 96 days. Participants will report daily anxiety level by SMS text message throughout the study. They will also answer self-report questionnaires, including questions on HA by proxy and own HA, 4 times during the study. Data will be submitted to structured visual analysis to inspect anxiety level, the variability of anxiety, trends, the overlap of data points among phases, when effects occur, and the consistency of data patterns across participants. Furthermore, randomization tests will be conducted for each participant to test the null hypothesis that PROXY will have no effect on participants\' anxiety.
RESULTS: The recruitment of parents began in June 2022. As of March 2, 2023, a total of 4 parents have been included in the study. Data collection was expected to cease in April 2023.
CONCLUSIONS: To the best of our knowledge, this protocol describes the only study of treatment for HA by proxy. As the prevalence of this condition is still unknown, a SCED was chosen because this method allows the inclusion of very few participants while still providing information on effects and treatment courses. Conducting the study with a replicated randomized phase design enables methodologically sound testing despite the inclusion of very few participants. The results will inform researchers on individual treatment courses and effects, which may direct future research in terms of the possible mechanisms of change, ideas for how to refine the treatment content, and how the treatment may be offered to patients in the future.
BACKGROUND: ClinicalTrials.gov NCT04830605; https://clinicaltrials.gov/study/NCT04830605.
UNASSIGNED: DERR1-10.2196/46927.