Colla Lucia, Fuller-Tyszkiewicz Matthew, Tomyn Adrian J, Richardson Ben, Tomyn Justin D
School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
Qual Life Res. 2016 Mar;25(3):517-24. doi: 10.1007/s11136-015-1150-0. Epub 2015 Oct 13.
While intervention effects in target outcomes have typically been tested based on change from baseline to post-intervention, such approaches typically ignore individual differences in change, including time taken to see improvement. The present study demonstrates how weekly patient-reported data may be used to augment traditional pre-post intervention evaluations in order to gain greater insights into treatment efficacy.
Two hundred and fifty-two adolescent boys and girls (M age = 13.6 years, SD = 0.6 years) from four secondary schools in Victoria, Australia, were assigned by school into control (n = 88) or intervention (n = 164) groups. The intervention group participated in a 6-week course designed to improve subjective wellbeing (SWB) by fostering resilience, coping skills, and self-esteem. In addition to baseline, post-intervention, and 3-month follow-up assessments of SWB, intervention group participants also completed weekly summarise of affective experiences for the duration of the intervention phase.
While standard pre-post data showed significant improvement in SWB for the intervention group relative to controls, weekly data showed individual differences in the trajectory of change during this intervention phase; low SWB individuals experienced initial worsening of symptoms followed by improvement in the second half of the intervention phase, whereas high SWB individuals experienced initial gains, followed by a plateau from Week 4 onwards.
Addition of weekly data provided greater insights into intervention effects by: (1) contradicting the notion that early responsiveness to treatment is predictive of level of improvement by post-intervention, and (2) providing data-based insights into ways to enhance the intervention.
虽然通常基于从基线到干预后的变化来测试干预对目标结果的影响,但这些方法通常忽略了变化中的个体差异,包括改善所需的时间。本研究展示了如何使用患者每周报告的数据来补充传统的干预前后评估,以便更深入地了解治疗效果。
来自澳大利亚维多利亚州四所中学的252名青少年男孩和女孩(平均年龄 = 13.6岁,标准差 = 0.6岁),按学校被分为对照组(n = 88)或干预组(n = 164)。干预组参加了一个为期6周的课程,旨在通过培养复原力、应对技能和自尊来提高主观幸福感(SWB)。除了对SWB进行基线、干预后和3个月随访评估外,干预组参与者还在干预阶段持续期间每周完成一次情感体验总结。
虽然标准的干预前后数据显示干预组的SWB相对于对照组有显著改善,但每周数据显示在这个干预阶段变化轨迹存在个体差异;低SWB个体经历了症状最初的恶化,随后在干预阶段后半期有所改善,而高SWB个体最初有改善,随后从第4周起趋于平稳。
添加每周数据通过以下方式更深入地了解了干预效果:(1)反驳了早期对治疗的反应能预测干预后改善程度的观点,(2)提供了基于数据的关于增强干预方法的见解。