Frank Fabian, Rummel-Kluge Christine, Berger Mathias, Bitzer Eva M, Hölzel Lars P
Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstraße 5, D-79104 Freiburg, Germany.
BMC Psychiatry. 2014 May 19;14:143. doi: 10.1186/1471-244X-14-143.
Depressive disorders are often recurrent and place a high burden on patients and their relatives. Psychoeducational groups for relatives may reduce relatives' burden, help prevent relapses in patients, and are recommended by the German "National Disease Management Guideline Unipolar Depression". Since there is limited knowledge on the provision of psychoeducational groups for relatives of persons in inpatient depression treatment, we conducted a survey among acute care hospitals in Germany.
We conducted a two-step cross-sectional survey. Step I consisted of a questionnaire asking the heads of all psychiatric/psychosomatic acute care hospitals in Germany (N = 512) whether psychoeducational groups for relatives were provided within depression treatment, and if not, the reasons for not implementing them. In group offering hospitals the person responsible for conducting psychoeducational groups received a detailed questionnaire on intervention characteristics (step II). We performed descriptive data analysis.
The response rate was 50.2% (N = 257) in step I and 58.4% in step II (N = 45). 35.4% of the responding hospitals offered psychoeducational groups for relatives of patients with depressive disorders. According to the estimates of the respondents, relatives of about one in five patients took part in psychoeducational groups in 2011. Groups were mostly provided by two moderators (62.2%) as continuous groups (77.8%), without patients' participation (77.8%), with up to ten participants (65.9%), consisting of four or fewer sessions (51.5%) which lasted between one and one and a half hours each (77.8%). The moderators in charge were mostly psychologists (43.9%) or physicians (26.8%). Approximately one third used published manuals. Reasons for not conducting such psychoeducational groups were lack of manpower (60.1%), time (44.9%) and financial constraints (24.1%). 25.3% mentioned adequate concepts of intervention as a required condition for initiating such groups.
Only a small proportion of relatives of patients with depressive disorders participated in psychoeducational groups in 2011 in Germany. Mostly short interventions were favoured and main implementation barriers were scarce resources. Brief interventions that fit with healthcare routine should be developed and tested within randomised controlled trials. This could promote the provision of psychoeducational groups for relatives as evidence-based practice in inpatient depression treatment in Germany.
抑郁症常常复发,给患者及其亲属带来沉重负担。为亲属提供的心理教育小组可能会减轻亲属的负担,有助于预防患者复发,并且得到了德国《单相抑郁症国家疾病管理指南》的推荐。由于关于为住院抑郁症患者亲属提供心理教育小组的相关知识有限,我们在德国的急症医院中开展了一项调查。
我们进行了一项两步横断面调查。第一步包括一份问卷,询问德国所有精神科/心身科急症医院(N = 512)的负责人,在抑郁症治疗过程中是否为亲属提供心理教育小组,若未提供,原因是什么。在提供小组的医院中,负责开展心理教育小组的人员收到一份关于干预特征的详细问卷(第二步)。我们进行了描述性数据分析。
第一步的回复率为50.2%(N = 257),第二步为58.4%(N = 45)。35.4%的回复医院为抑郁症患者的亲属提供心理教育小组。根据受访者估计,2011年约五分之一患者的亲属参加了心理教育小组。小组大多由两名主持人提供(62.2%),为连续小组(77.8%),患者不参与(77.8%),参与者最多十人(65.9%),由四节或更少课程组成(51.5%),每节课程持续一到一个半小时(77.8%)。负责的主持人大多是心理学家(43.9%)或医生(26.8%)。约三分之一使用已出版的手册。不开展此类心理教育小组的原因包括缺乏人力(60.1%)、时间(44.9%)和资金限制(24.1%)。25.3%提到适当的干预概念是启动此类小组的必要条件。
2011年在德国,只有一小部分抑郁症患者的亲属参加了心理教育小组。大多倾向于采用短期干预,主要实施障碍是资源稀缺。应开发适合医疗常规的简短干预措施,并在随机对照试验中进行测试。这可以促进为亲属提供心理教育小组,使其成为德国住院抑郁症治疗中的循证实践。