一项评估狼疮患者远程心理社会和运动干预的可行性和可接受性的随机对照试验:ADAPT可行性试验。

IF 2.9 3区 医学 Q2 RHEUMATOLOGY
Melanie Sloan, Thomas A Pollak, David D'Cruz, Wendy Diment, Michael Bosley, Elliott Lever, Farhana Mann, Benjamin Sloan, James Brimicombe, Stephen Morris, Felix Naughton
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引用次数: 0

摘要

狼疮患者可获得的社会心理支持有限,尽管生活质量大大降低。本研究评估了三种干预措施(两种心理社会干预,一种运动干预)的可接受性、可行性和有效性。狼疮患者(N = 124)被随机分配到对照组或在8-12周内远程提供三种干预措施中的一种:(1)倾听支持(The Wren项目),(2)在线普拉提课程,(3)短信和视频支持计划。干预后和基线后6个月的在线随访调查包括抑郁症(PHQ-8)、疲劳(FACIT-F)、恢复力(CD-RISC)、可接受性测量和我们共同设计的“ADAPT”测量。参与者的子样本完成了定性访谈。使用Hedge’s g和线性回归来估计有效性。所有干预措施在招募、时间和成本方面都是可行的,并且符合预先定义的可接受标准,即75%的人认为干预措施是可接受/高度可接受的。听力支持的帮助度评分最高,89%的人认为它经常/总是有帮助(对普拉提有62%的评价,对文本/视频有52%的评价)。鹪鹩训练组、普拉提训练组和文本/视频训练组中,有71%的参与者报告说,干预使他们的精神状态经常或总是更好。从质量上讲,听力支持的参与者重视谈话的“安全空间”,一些锻炼课程的参与者报告说身心健康有所改善。虽然短信和视频节目是可接受的,可行的,而且成本很低,41%的参与者宁愿接受不同的干预。建议的文本/视频改编包括更大的剪裁,特别是疾病旅程的阶段。普拉提的出勤率很低(只有55%的人参加了50%的课程)。与对照组相比,有效性估计有利于所有干预措施,尽管大多数改善随着时间的推移而减少。这些干预措施是可行的,并为患者所接受,具有潜在的有效性。需要进一步的研究来确定有效性。试验注册:ISRCTN72406488。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A randomised controlled trial to assess the feasibility and acceptability of remote psychosocial and exercise interventions for people with lupus: The ADAPT feasibility trial.

Limited psychosocial support is available for people with lupus despite the highly reduced quality of life. This study assessed the acceptability, feasibility, and effectiveness estimations, of three (two psychosocial, one exercise) interventions. Lupus patients (N = 124) were randomised to a control arm or one of three interventions delivered remotely over 8-12 weeks: (1) listening support (The Wren project), (2) online Pilates classes, and (3) a text message and video support programme. Online follow up surveys post-intervention and six-months post-baseline included validated instruments for depression (PHQ-8), fatigue (FACIT-F), resilience (CD-RISC), acceptability measures and our co-designed "ADAPT" measure. A subsample of participants completed qualitative interviews. Hedge's g and linear regression were used to estimate effectiveness. All interventions were feasible in terms of recruitment, time, and costs, and met the pre-defined acceptability criteria of > 75% rating the intervention as acceptable/highly acceptable. Helpfulness ratings were highest for listening support with 89% rating it as often/always helpful (62% for Pilates and 52% for Text/videos). Proportions of participants reporting that the intervention had made them feel better mentally often/always was 71% for The Wren, 57% for Pilates and 48% for the text/video group. Qualitatively, the listening support participants valued the "safe space" to talk, and several of the exercise class participants reported improvements to physical and mental health. Although the text message and video programme was acceptable, feasible, and very low cost, 41% of participants would rather have received a different intervention. Suggested text/video adaptations included greater tailoring, particularly to stage of disease journey. Attendance was low for Pilates (only 55% attended > 50% of classes). Estimates of effectiveness favoured all interventions compared to control, although most improvements reduced with time. The interventions were feasible to deliver and acceptable to patients, with indications of potential effectiveness. Further studies are needed to determine effectiveness.Trial registration: ISRCTN72406488.

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来源期刊
Rheumatology International
Rheumatology International 医学-风湿病学
CiteScore
7.30
自引率
5.00%
发文量
191
审稿时长
16. months
期刊介绍: RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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