混合模式或纯虚拟模式下的门诊集体药物使用障碍治疗与亲临现场治疗相比,患者感知到的影响。

IF 5.1 Q1 SUBSTANCE ABUSE
Substance Abuse and Rehabilitation Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI:10.2147/SAR.S481447
Nicholas L Bormann, Cindy J Stoppel, Stephan Arndt, Tyler S Oesterle
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引用次数: 0

摘要

目的:自 COVID-19 大流行以来,远程医疗的使用大幅增加。虽然虚拟医疗服务好处多多,但人们对患者在团体治疗环境中既通过虚拟方式又与咨询师面对面交流(混合模式)的体验却知之甚少。我们试图通过比较不同治疗模式下的患者调查数据来填补这一空白:在明尼苏达州农村地区的七个强化门诊(IOP)项目中,有药物使用障碍的成人患者自愿填写了一份调查问卷,对患者满意度、感知的治疗联盟、团体凝聚力以及从治疗中获得的启示进行了评估。从 2021 年 1 月 7 日开始,治疗小组要么全部采用虚拟模式,要么全部采用面对面模式,要么采用混合模式。调查于 2022 年 1 月 1 日开始。协方差分析(ANCOVA)检验了治疗组之间的差异。每个调查问题都使用了不同的模型,因变量为调查回答,检验指标为治疗组类型,协变量为住院时间和年龄。模型估计值和基于模型的标准偏差用于计算 Cohen's d效应大小:共纳入了 1037 人的调查结果,每位受访者一份调查问卷。收到调查表后,数据已被去标识,因此无法进行具体的人口统计学比较。在混合组中,与面对面调查相比,调查回答没有明显差异,影响大小可以忽略不计。在 8 个问题中,有 6 个问题的虚拟回答明显不如面对面回答;效应大小估计值超过了小效应大小临界值,95% CI 超过了中效应临界值:结论:创建一个患者可以同时参加虚拟和面对面治疗的小组模式,似乎可以提高治疗联盟感、小组凝聚力和治疗洞察力,而仅有虚拟小组可能会比面对面治疗产生负面影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient Perceived Impact of Outpatient Group Substance Use Disorder Treatment in a Hybrid Model or Virtual-Only Model Relative to In-Person Delivery.

Purpose: Telehealth use has grown tremendously since the onset of the COVID-19 pandemic. While the benefits of virtual care delivery are numerous, little is known about patient experiences in group treatment settings when members join both virtually and in person with the counselor (a hybrid model). We sought to fill this gap by comparing patient survey data across care delivery models.

Patients and methods: Adult patients with a substance use disorder enrolled at one of seven intensive outpatient (IOP) programs in rural Minnesota voluntarily completed a questionnaire assessing patient satisfaction, perceived therapeutic alliance, group cohesion, and insight gained from treatment. Starting 7/1/2021, groups were either all virtual, all in-person, or a hybrid model. The survey began on 1/1/2022. Analysis of covariance (ANCOVA) tested for differences among treatment groups. Separate models were used for each survey question, where the dependent variable was the survey response, the test of interest being treatment group-type, with covariates of length of stay and age. Model estimates and model-based standard deviations were used to calculate the Cohen's d effect size.

Results: Survey results from a total of 1037 individuals were included, one survey per respondent. Data was deidentified upon receipt of the survey, preventing specific demographic comparisons. For the hybrid groups, no significant differences were noted with survey responses relative to in-person, with negligible to small effect sizes seen. When comparing virtual to in-person, virtual was rated as significantly worse than in-person on 6 of the 8 questions; effect size estimates exceeded the small effect size cut-off, and the 95% CI exceeded the moderate cut-off.

Conclusion: Creating a group model where patients can attend both virtually and in-person together appears to improve perceived therapeutic alliance, group cohesion, and treatment insight, compared to virtual-only groups, which may have a negative effect relative to in-person.

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