Lundgren Johan, Andersson Gerhard, Dahlström Örjan, Jaarsma Tiny, Köhler Anita Kärner, Johansson Peter
Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Patient Educ Couns. 2015 Aug;98(8):935-42. doi: 10.1016/j.pec.2015.04.013. Epub 2015 Apr 27.
The aim was (1) to describe the development of a guided internet-based CBT (ICBT) program adapted to patients with heart failure (HF) and (2) to evaluate the feasibility of the ICBT program in regard to depressive symptoms, the time used by health care providers to give feedback, and participants' perceptions of the ICBT program.
A multi-professional team developed the program and seven HF patients with depressive symptoms were recruited to the study. The Patient Health Questionnaire-9 (PHQ-9) and the Montgomery Åsberg Depression Rating-Self-rating scale (MADRS-S) were used to measure depression, and patients were interviewed about their perceptions of the program.
Based on research in HF and CBT, a nine-week program was developed. The median depression score decreased from baseline to the end of the study (PHQ-9: 11-8.5; MADRS-S: 25.5-16.5) and none of the depression scores worsened. Feedback from health care providers required approximately 3h per patient. Facilitating perceptions (e.g. freedom of time) and demanding perceptions (e.g. part of the program demanded a lot of work) were described by the patients.
The program appears feasible and time-efficient. However, the program needs to be evaluated in a larger randomized study.
旨在（1）描述一种针对心力衰竭（HF）患者改编的基于互联网的指导性认知行为疗法（ICBT）项目的开发过程，以及（2）评估ICBT项目在抑郁症状、医疗保健提供者提供反馈所用时间以及参与者对ICBT项目的认知方面的可行性。
一个多专业团队开发了该项目，并招募了7名有抑郁症状的HF患者参与研究。使用患者健康问卷-9（PHQ-9）和蒙哥马利-Åsberg抑郁自评量表（MADRS-S）来测量抑郁程度，并就患者对该项目的认知进行访谈。
基于对HF和CBT的研究，开发了一个为期9周的项目。从基线到研究结束，抑郁得分中位数有所下降（PHQ-9：从11降至8.5；MADRS-S：从25.5降至16.5），且抑郁得分均未恶化。医疗保健提供者为每位患者提供反馈大约需要3小时。患者描述了便利性认知（如时间自由）和苛刻性认知（如项目的一部分需要大量工作）。
该项目似乎可行且具有时间效率。然而，该项目需要在更大规模的随机研究中进行评估。
