[精神障碍远程医疗:基于电话的护理方法的介绍和初步结果]。

IF 0.6 4区 医学 Q4 CLINICAL NEUROLOGY
Georg Bornemann
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引用次数: 0

摘要

目的将介绍一项针对抑郁症、焦虑症和压力症患者的电话健康计划,该计划已在一家私营医疗保险公司的标准医疗服务中实施,并将介绍初步评估结果:该项目由医疗专业人员为患者提供为期数月的电话支持,重点是教授心理教育内容、行为治疗技术和情感支持。本项目采用了德文版的 DASS 21 问卷,该问卷用于检测抑郁、焦虑、压力以及整体心理压力等方面的困扰。本报告介绍了该计划前 11 个月所有参与者的人口统计数据和问卷调查结果,这些参与者在两个时间点填写了问卷。经过五个月的辅导后,DASS 21(分项)得分的降低被定义为主要终点。计算方法为因变量 t 检验(α=0.05):199 名参与者中有 86 人(43.2%)填写了两份问卷。参与者平均年龄为 49.5 岁,以女性为主(61.6%)。辅导时间总计 170 天(SD=58),200 分钟(81)。平均而言,这些分钟分布在 5.6(1.9)次通话中。在基线上,所有子类别的得分都有所提高(抑郁:7.13 [4.99];焦虑:4.49 [4.07];压力:9.85 [4.16]):9.85 [4.16];总分:21.47 [11.54])。五个月后,测得各项参数均有所下降(抑郁:- 2.14 [3.99],Cohen's d=0.54;焦虑:- 1.65 [3.36],d=0.49;压力:- 2.24 [4.81],d=0.49):- 2.24 [4.81],d=0.47;总分:- 6.03 [10.70];d=0.56;各分值的 p <0.001)。按护理开始时的压力严重程度细分,有几个子类别显示,随着压力严重程度的增加,得分减少的幅度也在增加,效应大小为中等到较大:结论:所描述的电话计划作为一种治疗精神疾病的辅助方法是很有前景的。由于采用的是事前-事后研究设计,因此无法对该计划的有效性做出最终结论。然而,基于该项目在实施过程中对心理压力的明显改善,包括相关的效应大小,建议在受控条件下对这一设置进行进一步评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Telemedicine for mental disorders: Presentation and initial results of a telephone-based care approach].

Objective: A telephone-based health program for people with depressive and anxiety disorders as well as stress, already implemented in the standard care of a private health insurance company, as well as the initial evaluation results will be presented.

Methods: The program, based on several months of telephone support for patients from medical professionals, focuses on teaching psychoeducational content, behavioral therapy techniques, and emotional support. In the current program, the German version of the DASS 21 questionnaire was used, which detects distress in the dimensions of depression, anxiety and stress as well as overall psychological stress. The demographic data and the questionnaire results of all participants from the first eleven months of the program, who completed questionnaires at two time points, are presented. The reductions in the DASS 21 (sub)scores after five months of coaching were defined as the primary endpoints. The basis for calculation was the t-test for dependent samples (α=0.05).

Results: Two completed questionnaires were available from 86 of 199 participants (43.2%). The population was on average 49.5 years old and predominantly female (61.6%). In total, coaching lasted 170 (SD=58) days and 200 (81) minutes. On average, these minutes were distributed over 5.6 (1.9) calls. At baseline, there were increased scores in all subcategories (depression: 7.13 [4.99]; anxiety: 4.49 [4.07]; stress: 9.85 [4.16]; total: 21.47 [11.54]). After five months, a reduction in each parameter was measured (depression: - 2.14 [3.99], Cohen's d=0.54; anxiety: - 1.65 [3.36], d=0.49; stress: - 2.24 [4.81], d=0.47; total: - 6.03 [10.70]; d=0.56; p < 0.001 for each). Broken down by severity of stress at the start of care, several subcategories showed an increase in score reduction with increasing severity, with medium to large effect sizes.

Conclusion: The telephone program described is promising as an accompanying approach to treatment of mental illness. Due to the pre-post study design, the results presented do not allow a final statement to be made about the effectiveness of the program. However, based on the significant improvements in psychological stress shown over the course of the program, including relevant effect sizes, a further evaluation of this setting under controlled conditions is recommended.

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来源期刊
CiteScore
1.10
自引率
16.70%
发文量
139
审稿时长
6-12 weeks
期刊介绍: Fundiertes Wissen für den Berufsalltag Relevante Originalarbeiten Informative Übersichten zu wichtigen Themen Fortbildungsteil mit Zertifizierung – 36 CME-Punkte pro Jahr Interessante Kasuistiken Referiert & kommentiert: Internationale Studien Aktuelles zu Begutachtung und Neurobiologie International gelistet und häufig zitiert
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