Seeley John R, Manitsas Tara, Gau Jeff M
a Oregon Research Behavioral Intervention Strategies, Inc. , Eugene , OR , USA.
b NorthWest Senior & Disability Services , Salem , OR , USA.
Aging Ment Health. 2017 Sep;21(9):968-974. doi: 10.1080/13607863.2016.1186152. Epub 2016 May 24.
The majority of older adults experiencing depression and/or anxiety do not receive adequate treatment due to limited access to evidence-based practices. Low intensity cognitive-behavioral intervention has been established as an evidence-based practice with the potential to increase the reach to older adults. The purpose of the current study is to evaluate the feasibility, acceptability, and potential efficacy of a low intensity, peer-supported, cognitive-behavioral intervention for mild to moderate depression and/or anxiety delivered by a local intergovernmental agency serving older adults.
Sixty-two older adults (81% female) between 55 and 96 years of age were randomly assigned to either a peer-facilitated cognitive-behavioral bibliotherapy condition (n = 31) or a wait-list control condition (n = 31).
The 10-week feasibility trial data indicated that (1) a majority of the participants were highly engaged in the intervention with an average number of 7.3 peer sessions attended and 2.1 workbooks completed, (2) the participants were quite satisfied with the peer mentoring sessions and moderately satisfied with the workbooks, and (3) there were clinically meaningful reductions in depressive symptoms for those assigned to the treatment condition compared to those that were wait-listed (d = .43), though the effect was non-significant (p = .099) due to the small sample size. The evidence for the impact on reducing anxiety symptoms was more equivocal with a non-significant, small effect size favoring the treatment condition.
The pilot study provided preliminary evidence for the feasibility, acceptability, and potential efficacy of the peer-facilitated low intensity cognitive-behavioral therapy intervention approach.
由于难以获得循证实践,大多数患有抑郁症和/或焦虑症的老年人未得到充分治疗。低强度认知行为干预已被确立为一种循证实践,有可能扩大对老年人的覆盖范围。本研究的目的是评估由当地一个为老年人服务的政府间机构提供的针对轻度至中度抑郁症和/或焦虑症的低强度、同伴支持的认知行为干预的可行性、可接受性和潜在疗效。
62名年龄在55至96岁之间的老年人(81%为女性)被随机分配到同伴促进的认知行为阅读疗法组(n = 31)或等待名单对照组(n = 31)。
为期10周的可行性试验数据表明,(1)大多数参与者高度参与干预,平均参加7.3次同伴辅导课程,完成2.1本练习册;(2)参与者对同伴辅导课程非常满意,对练习册中度满意;(3)与等待名单上的人相比,分配到治疗组的人的抑郁症状有临床意义的减轻(d = 0.43),尽管由于样本量小,效果不显著(p = 0.099)。对减轻焦虑症状影响的证据更不明确,有利于治疗组的效果大小不显著且较小。
该初步研究为同伴促进的低强度认知行为疗法干预方法的可行性、可接受性和潜在疗效提供了初步证据。