South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, Northfield, South Australia, Australia.
Arch Phys Med Rehabil. 2012 Nov;93(11):2100-8. doi: 10.1016/j.apmr.2012.06.002. Epub 2012 Jun 14.
To determine whether an individualized counseling intervention delivered by telephone-telecounseling-feasibly improves the emotional adjustment of adults with a newly acquired spinal cord injury (SCI).
Randomized controlled trial.
Spinal injuries unit of a rehabilitation center.
Adults (N=40) aged 18 or older, who were recently discharged home from inpatient spinal rehabilitation, were randomly assigned to a telecounseling treatment or standard-care control group. All participants had recently received psychological treatment as inpatients in order to help assist them in adjusting to their disability. Referral to the inpatient psychology service was therefore a key indicator of participants' baseline distress levels and, consequently, their need for counseling support postdischarge.
Seven telecounseling sessions were delivered over a 12-week period by a single psychologist (D.D.). Pre- and postintervention data, plus a 3-month follow-up assessment, were compared with that of an SCI control group who received standard care.
Psychosocial outcome was measured using the following: Depression Anxiety Stress Scale-21; Mini International Neuropsychiatric Interview; Spinal Cord Lesion Emotional Wellbeing and Coping Strategies Questionnaires; and the Multidimensional Measure of Social Support. Cost-effectiveness and clinical feasibility were also evaluated.
Telecounseling participants reported clinical improvements in depression and anxiety and aspects of SCI coping immediately postintervention. However, these treatment gains were not statistically significant. Additionally, treatment effects were minimal at 3-month follow-up. Delivery related outcomes, including participation rate and cost analyses, were all positive.
The results suggest that continued psychological services for individuals reporting distress during their inpatient rehabilitation is important and that such services can be delivered by telephone cost-effectively and efficiently. However, the long-term benefits of telecounseling, once ceased, were not demonstrated.
确定通过电话-远程咨询提供的个体化咨询干预是否可以改善新获得脊髓损伤（SCI）的成年人的情绪调整。
随机对照试验。
康复中心的脊柱损伤病房。
年龄在 18 岁或以上的成年人，最近从住院脊髓康复中出院回家，被随机分配到远程咨询治疗或标准护理对照组。所有参与者最近都接受过住院心理治疗，以帮助他们适应残疾。因此，向住院心理服务机构转介是参与者基线痛苦水平的关键指标，也是他们在出院后需要咨询支持的关键指标。
由一位心理学家（D.D.）在 12 周内进行了 7 次远程咨询。在干预前后的数据，加上 3 个月的随访评估，与接受标准护理的 SCI 对照组进行了比较。
使用以下方法测量心理社会结果：抑郁焦虑应激量表-21；迷你国际神经精神访谈；脊髓损伤情绪健康和应对策略问卷；多维社会支持测量。还评估了成本效益和临床可行性。
远程咨询组报告说，在干预后立即在抑郁和焦虑以及 SCI 应对方面有临床改善。然而，这些治疗效果并不显著。此外，在 3 个月的随访中，治疗效果微乎其微。与参与率和成本分析等相关的交付结果均为积极。
结果表明，为在住院康复期间报告痛苦的个人提供持续的心理服务很重要，并且这种服务可以通过电话以具有成本效益和高效率的方式提供。然而，远程咨询一旦停止，其长期益处并未得到证明。
