Yale University, USA; VA Connecticut Healthcare System, USA.
Yale University, USA.
Health Informatics J. 2019 Mar;25(1):41-50. doi: 10.1177/1460458216683536. Epub 2016 Dec 28.
The impact of computer-based cognitive-behavioral self-help therapy programs is limited by high attrition. This study explored reactions to computer-based cognitive-behavioral self-help therapy use among individuals not completing a full treatment course. Individuals receiving outpatient substance use disorder treatment at a Veterans Health Administration clinic who enrolled in a study implementing a computer-based cognitive-behavioral self-help therapy for insomnia, but subsequently dropped out prior to completion, were interviewed. Reactions to use and reasons for attrition were explored through thematic analysis of interviews. Among barriers to use, themes of competing demands, personal attributes, the computer-based format of computer-based cognitive-behavioral self-help therapies, and negative experiences with the specific program used were identified. Among facilitators of use, themes of personal support, the computer-based cognitive-behavioral self-help therapy format, and personal attributes were identified. Recommendations for future implementation efforts to include additional person-to-person contact during computer-based cognitive-behavioral self-help therapy participation were made. These themes may be employed to develop strategies for computer-based cognitive-behavioral self-help therapy implementation in order to maximize program engagement and completion.
基于计算机的认知行为自助疗法的效果受到高脱落率的限制。本研究探讨了未完成完整疗程的个体对基于计算机的认知行为自助疗法使用的反应。在退伍军人事务部诊所接受门诊物质使用障碍治疗并参加一项针对失眠的基于计算机的认知行为自助疗法研究但随后在完成前退出的个体接受了访谈。通过对访谈的主题分析探讨了使用反应和脱落原因。在使用障碍中，确定了竞争需求、个人属性、基于计算机的认知行为自助疗法的计算机格式以及对使用的特定程序的负面体验等主题。在使用促进因素中，确定了个人支持、基于计算机的认知行为自助疗法格式和个人属性等主题。建议在未来的实施工作中，在参与基于计算机的认知行为自助疗法时增加更多的人际接触。可以采用这些主题来制定基于计算机的认知行为自助疗法实施策略，以最大限度地提高项目参与度和完成度。
