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通过基于民用社区的远程医疗网络,为持久自由行动/伊拉克自由行动的退伍军人提供创伤后应激障碍治疗。

Posttraumatic stress disorder treatment for Operation Enduring Freedom/Operation Iraqi Freedom combat veterans through a civilian community-based telemedicine network.

作者信息

Ziemba Steven J, Bradley Nicola S, Landry Lori-Ann P, Roth Claire H, Porter Linda S, Cuyler Robert N

机构信息

1 Phoebe Putney Memorial Hospital , Albany, Georgia .

出版信息

Telemed J E Health. 2014 May;20(5):446-50. doi: 10.1089/tmj.2013.0312. Epub 2014 Mar 11.

Abstract

BACKGROUND

Telemedicine holds great potential to improve access to care and to reduce barriers to treatment for military populations with posttraumatic stress disorder (PTSD). This study sought to integrate the use of telemedicine mental health treatment services by a community healthcare provider to military populations residing in a rural location and to compare the equivalency of cognitive behavioral therapy (CBT) administered via telemedicine and traditional face-to-face therapy.

SUBJECTS AND METHODS

Study subjects were men or women 18 years of age or older who had served in Operation Enduring Freedom (OEF) and/or Operation Iraqi Freedom (OIF) and were diagnosed with PTSD. The 18 study subjects were randomized and provided 10 weekly therapy sessions of CBT. Pre- and post-intervention assessments were conducted using the Clinician Administered PTSD Scale (CAPS), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Life Events Checklist, and SF-36v2® (QualityMetric, Lincoln, RI) Health Survey.

RESULTS

The CAPS, HAM-A, and MADRS each demonstrated lower scores, signifying improvement, and 69% of subjects experienced a clinically significant change in the CAPS. Patient satisfaction results indicated greater satisfaction for telemedicine as opposed to traditional face-to-face treatment.

CONCLUSIONS

Findings reveal a trend expressing the equivalence of telemedicine and face-to-face therapy when treating OEF/OIF veterans with PTSD among rural populations by a community provider. It further demonstrates the successful collaboration between a community healthcare provider and the military healthcare system.

摘要

背景

远程医疗在改善创伤后应激障碍(PTSD)军人获得医疗服务的机会以及减少治疗障碍方面具有巨大潜力。本研究旨在整合社区医疗服务提供者对居住在农村地区的军人使用远程心理健康治疗服务,并比较通过远程医疗实施的认知行为疗法(CBT)与传统面对面疗法的等效性。

受试者与方法

研究对象为18岁及以上曾参加持久自由行动(OEF)和/或伊拉克自由行动(OIF)且被诊断为PTSD的男性或女性。18名研究对象被随机分组,并接受为期10周的CBT治疗。干预前后使用临床医生管理的PTSD量表(CAPS)、汉密尔顿焦虑量表(HAM - A)、蒙哥马利 - 阿斯伯格抑郁量表(MADRS)、生活事件清单和SF - 36v2®(QualityMetric,林肯,罗德岛)健康调查进行评估。

结果

CAPS、HAM - A和MADRS的得分均降低,表明有所改善,69%的受试者在CAPS上有临床显著变化。患者满意度结果显示,与传统面对面治疗相比,患者对远程医疗的满意度更高。

结论

研究结果显示,在社区医疗服务提供者对农村地区患有PTSD的OEF/OIF退伍军人进行治疗时,远程医疗与面对面治疗具有等效性。这进一步证明了社区医疗服务提供者与军事医疗系统之间的成功合作。

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