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接受促进干预对糖尿病患者接受基于互联网的抑郁干预的影响:一项随机对照试验。

Impact of an acceptance facilitating intervention on diabetes patients' acceptance of Internet-based interventions for depression: a randomized controlled trial.

机构信息

Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany; Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Germany.

Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.

出版信息

Diabetes Res Clin Pract. 2014 Jul;105(1):30-9. doi: 10.1016/j.diabres.2014.04.031. Epub 2014 May 10.

Abstract

AIMS

To (1) determine diabetes patients' acceptance of Internet-based interventions (IBIs) for depression, to (2) examine the effectiveness of an acceptance facilitating intervention (AFI) and to (3) explore subgroup specific effects.

METHODS

141 diabetes patients from two inpatient rehabilitation units and one outpatient clinic in Germany were randomly allocated to an intervention (IG) and a no-intervention control group (CG). The IG received an AFI consisting of a personal information session before filling-out a questionnaire on patients' acceptance of IBIs, predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, and Internet anxiety) as well as sociodemographic, depression-related and diabetes-related variables. The CG filled out the questionnaire immediately. Patients' acceptance of IBIs was measured with a four-item scale (sum-score ranging from 4 to 20).

RESULTS

The CG showed a low (50.7%) to medium (40.8%) acceptance with only 8.5% of all diabetes patients reporting a high acceptance of IBIs for depression. The AFI had no significant effect on acceptance (IG: M=10.55, SD=4.69, n=70; KG: M=9.65, SD=4.27, n=71; d=0.20 [95%-CI: -0.13;0.53]) and the predictors of acceptance. Yet, subgroup analyses yielded a trend for depressed, diabetes-related distressed, female and younger (<59) participants and for those who do not frequently use the Internet to profit from the AFI.

CONCLUSION

Diabetes patients show a rather low acceptance toward IBIs for depression. Findings indicate that the AFI is likely to be effective in the subgroup of depressed, diabetes-related distressed, female or younger diabetes patients, but not in the whole target population. Hence, AFIs might need to be tailored to the specific needs of subpopulations.

摘要

目的

(1)确定糖尿病患者对基于互联网的干预措施(IBI)治疗抑郁的接受程度,(2)检验接受促进干预(AFI)的有效性,(3)探索亚组的特定效果。

方法

141 名来自德国两家住院康复病房和一家门诊诊所的糖尿病患者被随机分配到干预组(IG)和无干预对照组(CG)。IG 接受了一个 AFI,包括在填写关于患者对 IBI 接受度的问卷之前的个人信息会议,接受度的预测因素(绩效预期、努力预期、社会影响、促进条件和网络焦虑)以及社会人口统计学、抑郁相关和糖尿病相关变量。CG 立即填写问卷。患者对 IBI 的接受程度用四项量表(总分范围为 4 到 20)进行测量。

结果

CG 的接受度较低(50.7%)到中等(40.8%),只有 8.5%的糖尿病患者报告对 IBI 治疗抑郁有较高的接受度。AFI 对接受度没有显著影响(IG:M=10.55,SD=4.69,n=70;KG:M=9.65,SD=4.27,n=71;d=0.20 [95%-CI:-0.13;0.53])和接受度的预测因素。然而,亚组分析显示,抑郁、糖尿病相关困扰、女性和年轻(<59 岁)患者以及不经常使用互联网获益于 AFI 的患者有趋势。

结论

糖尿病患者对 IBI 治疗抑郁的接受程度较低。研究结果表明,AFI 可能对抑郁、糖尿病相关困扰、女性或年轻的糖尿病患者亚组有效,但对整个目标人群无效。因此,AFI 可能需要针对特定亚群的需求进行定制。

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