Montero-Marín Jesús, Prado-Abril Javier, Botella Cristina, Mayoral-Cleries Fermin, Baños Rosa, Herrera-Mercadal Paola, Romero-Sanchiz Pablo, Gili Margalida, Castro Adoración, Nogueira Raquel, García-Campayo Javier
Faculty of Health and Sports, University of Zaragoza, Huesca, Spain.
J Med Internet Res. 2015 Mar 10;17(3):e67. doi: 10.2196/jmir.3985.
One-quarter of the world's population will suffer from depression symptoms at some point in their lives. Mental health services in developed countries are overburdened. Therefore, cost-effective interventions that provide mental health care solutions such as Web-based psychotherapy programs have been proposed.
The intent of the study was to identify expectations regarding Web-based psychotherapy for the treatment of depression in primary care among patients and health professionals that might facilitate or hinder its effects.
The expectations of untreated patients and health professionals were examined by means of interviews and focus groups. There were 43 participants (20 patients with mild and moderate levels of depression, 11 primary care physicians, and 12 managers; 22 of them for interviews and 21 for groups). A thematic content analysis from the grounded theory for interviews, and an analysis of the discursive positions of participants based on the sociological model for groups were performed. Interpretations were achieved by agreement between three independent analysts.
All participants showed a good general acceptance of Web-based psychotherapy, appreciating possible advantages and improvements. Patients, physicians, and managers shared the same conceptualization of their expectations, although highlighting different aspects. Patients focused on the need for individualized and personalized interaction, while professionals highlighted the need for the standardization of the program. Physicians were concerned with extra workload, while managers were worried about optimizing cost-effectiveness.
Expectations of the different participants can conflict with each other. Finding a balanced position among them is needed if we are to harmoniously implement effective Web-based interventions for depression in routine clinical practice.
世界上四分之一的人口在人生的某个阶段会出现抑郁症状。发达国家的心理健康服务负担过重。因此，有人提出了具有成本效益的干预措施，如基于网络的心理治疗项目，以提供心理健康护理解决方案。
本研究旨在确定患者和卫生专业人员对基于网络的心理治疗在初级保健中治疗抑郁症的期望，这些期望可能会促进或阻碍其效果。
通过访谈和焦点小组来研究未接受治疗的患者和卫生专业人员的期望。共有43名参与者（20名轻度和中度抑郁症患者、11名初级保健医生和12名管理人员；其中22人接受访谈，21人参加小组讨论）。对访谈采用扎根理论进行主题内容分析，对小组讨论采用基于社会学模型的参与者话语立场分析。由三名独立分析师达成共识来实现解读。
所有参与者对基于网络的心理治疗普遍接受度较高，认可其可能的优势和改进之处。患者、医生和管理人员对期望的概念化相同，尽管侧重点不同。患者关注个性化互动的需求，而专业人员强调项目标准化的必要性。医生担心额外的工作量，而管理人员则担心成本效益的优化。
不同参与者的期望可能相互冲突。如果我们要在常规临床实践中和谐地实施有效的基于网络的抑郁症干预措施，就需要在这些期望之间找到一个平衡的立场。
