University of New England, Armidale NSW 2351, Australia.
J Psychosom Res. 2010 Mar;68(3):245-51. doi: 10.1016/j.jpsychores.2009.07.023. Epub 2009 Nov 3.
The present study examined the efficacy of bibliotherapy in assisting individuals experiencing distress related to tinnitus.
One hundred sixty-two tinnitus sufferers from Australia participated in a study designed to examine the effectiveness of a cognitive-behaviorally based self-help book in reducing distress. To maximize the ecological validity of the findings, we excluded no individuals interested in treatment for tinnitus-related distress.
The experimental condition lost 35% of participants at postassessment, compared to 10% in the control group. In an analysis of participants who completed postintervention assessment, those assigned to the intervention condition, who received a tinnitus self-help book, showed significantly less tinnitus-related distress and general distress 2 months later compared to those assigned to the waiting list control condition. The intervention group's reduction in tinnitus-related distress and general distress from preintervention to postintervention 2 months later was significant, and these participants maintained a significant reduction in distress on follow-up 4 months after they received the tinnitus self-help book. A long-term follow-up of all participants, who at that time had received the book at least a year previously, showed a significant reduction in tinnitus distress. Although these group differences and pre-post changes were significant, effect sizes were small. Intention-to-treat analyses showed no significant effect for between-groups analyses, but did show a significant effect for the 1-year follow-up pre-post analysis.
Information on the effectiveness of using a self-help book, without therapist assistance, in alleviating distress is important, as bibliotherapy can provide inexpensive treatment that is not bound by time or place.
本研究旨在检验阅读疗法对减轻与耳鸣相关的痛苦的疗效。
来自澳大利亚的 162 名耳鸣患者参与了一项研究,旨在检验一种基于认知行为的自助书籍在减轻痛苦方面的有效性。为了使研究结果具有最大的生态效度,我们没有排除任何对耳鸣相关痛苦治疗感兴趣的人。
实验组在后期评估时失去了 35%的参与者,而对照组则失去了 10%。在对完成干预后评估的参与者进行分析时,那些被分配到干预组的人,即接受耳鸣自助书籍的人,与被分配到等待名单对照组的人相比,在 2 个月后显示出明显较少的耳鸣相关痛苦和一般痛苦。与干预前相比,干预组在 2 个月后的后期评估中,耳鸣相关痛苦和一般痛苦的减少具有统计学意义,而且这些参与者在接受耳鸣自助书籍后 4 个月的随访中仍保持明显的痛苦减轻。对所有参与者的长期随访显示,他们至少在一年前接受了书籍,耳鸣痛苦明显减轻。尽管这些组间差异和前后变化具有统计学意义,但效果大小较小。意向治疗分析显示,组间分析没有显著效果,但在 1 年随访的前后分析中显示出显著效果。
提供关于在没有治疗师帮助的情况下使用自助书籍减轻痛苦的有效性的信息很重要,因为阅读疗法可以提供经济实惠且不受时间和地点限制的治疗。