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美国军队创伤后应激障碍居家远程心理健康治疗的可行性与安全性评估

An Evaluation of the Feasibility and Safety of a Home-Based Telemental Health Treatment for Posttraumatic Stress in the U.S. Military.

作者信息

Luxton David D, Pruitt Larry D, O'Brien Karen, Kramer Gregory

机构信息

1 National Center for Telehealth and Technology , Joint Base Lewis-McChord, Washington.

2 Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine , Seattle, Washington.

出版信息

Telemed J E Health. 2015 Nov;21(11):880-6. doi: 10.1089/tmj.2014.0235. Epub 2015 Jun 23.

Abstract

BACKGROUND

Although home-based telemental health options have the potential to greatly expand the range of services available to U.S. military service members, there remains a need to demonstrate that home-based care is technically feasible, safe, and effective and meets the military health system's standards of care before widespread implementation can be achieved. The purpose of this preliminary study was to evaluate the feasibility and safety of providing U.S. military service members with a behavioral health treatment delivered directly to the home using videoconferencing.

MATERIALS AND METHODS

Ten previously deployed soldiers volunteered to complete eight sessions of a novel behavioral activation treatment for posttraumatic stress disorder. The primary clinical outcomes assessed included symptoms of posttraumatic stress and depression. Patient safety data and attitudes about seeking mental health services, treatment satisfaction, treatment adherence, and treatment compliance were also assessed.

RESULTS

Clinically significant reductions in posttraumatic stress symptom severity and depression symptoms were observed. Soldiers indicated high levels of satisfaction with the treatment, and there were no adverse events requiring activation of emergency safety procedures. Technical problems associated with the network were observed but successfully mitigated.

CONCLUSIONS

The results provide initial support for the feasibility and safety of telemental health treatments delivered by videoconferencing to the homes of soldiers. The optimal technical infrastructure needs to be determined to support expansion of synchronous videoconferencing capabilities to the home. The findings provide preliminary evidence of the feasibility, safety, and high user satisfaction with home-based telemental health in the military setting.

摘要

背景

尽管基于家庭的远程心理健康服务有潜力极大地扩展美国现役军人可获得的服务范围,但在广泛实施之前,仍需证明这种居家护理在技术上是可行的、安全有效的,并且符合军事卫生系统的护理标准。这项初步研究的目的是评估通过视频会议直接为美国现役军人提供居家行为健康治疗的可行性和安全性。

材料与方法

十名曾部署过的士兵自愿完成八节针对创伤后应激障碍的新型行为激活治疗课程。评估的主要临床结果包括创伤后应激症状和抑郁症状。还评估了患者安全数据以及对寻求心理健康服务的态度、治疗满意度、治疗依从性和治疗合规性。

结果

观察到创伤后应激症状严重程度和抑郁症状有临床上显著的减轻。士兵们对治疗表示高度满意,并且没有需要启动紧急安全程序的不良事件。观察到与网络相关的技术问题,但已成功缓解。

结论

这些结果为通过视频会议为士兵家庭提供远程心理健康治疗的可行性和安全性提供了初步支持。需要确定最佳技术基础设施,以支持将同步视频会议功能扩展到家庭。这些发现为军事环境中基于家庭的远程心理健康的可行性、安全性和高用户满意度提供了初步证据。

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