North Carol S, Pollio David E, Sims Omar T, Jain Mamta K, Brown Geri R, Downs Dana L, Lisker-Melman Mauricio, Hong Barry A
aThe Altshuler Center for Education & Research, Metrocare Services Departments of bPsychiatry cInternal Medicine, Division of Infectious Diseases dInternal Medicine, Division of Digestive and Liver Diseases, VA North Texas Health Care System, The University of Texas Southwestern Medical Center, Dallas, Texas eDepartment of Social Work, The University of Alabama at Birmingham, College of Arts and Sciences, Birmingham, Alabama Departments of fInternal Medicine, Division of Gastroenterology gPsychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
Eur J Gastroenterol Hepatol. 2017 Jun;29(6):679-685. doi: 10.1097/MEG.0000000000000860.
A successful psychoeducation program for serious mental illness, PsychoEducation Responsive to Families (PERF), was modified for hepatitis C virus (HCV). An effectiveness study was carried out comparing HCV-PERF with didactic education.
A sample of 309 adult HCV patients was recruited from three outpatient settings and randomized (60% HCV-PERF, 40% didactic control). Groups met for 90 min bimonthly for 6 months following separate structured protocols. HCV-PERF sessions included a didactic curriculum developed uniquely for groups by member choice, with group problem-solving and support interactions. Patients were assessed at baseline, after the intervention, and 1 year later. Demographic and HCV-related variables and structured diagnostic interview data were obtained.
Both groups improved significantly on major depression and alcohol and drug use, quality of life, risk behaviors, and treatment satisfaction, and worsened on disability and perceived HCV-related problems. Intervention groups did not differ on outcomes.
Even though the active intervention did not achieve a significant improvement relative to the control condition, the observable improvements in both conditions warrant further exploration of the contributions of education and support as potentially important elements of HCV behavioral intervention. Further study is needed to identify elements common to education interventions that may be contributory to the improved outcomes over time.
针对严重精神疾病的一项成功的心理教育项目——“家庭响应式心理教育”(PERF),被改编用于丙型肝炎病毒(HCV)。开展了一项有效性研究,将HCV - PERF与说教式教育进行比较。
从三个门诊机构招募了309名成年HCV患者样本,并进行随机分组(60%为HCV - PERF组,40%为说教式对照组)。两组按照各自独立的结构化方案,每两个月会面一次,每次90分钟,共持续6个月。HCV - PERF课程包括一个根据成员选择为小组专门开发的说教课程,以及小组问题解决和支持互动环节。在基线、干预后及1年后对患者进行评估。获取了人口统计学和HCV相关变量以及结构化诊断访谈数据。
两组在重度抑郁、酒精和药物使用、生活质量、风险行为以及治疗满意度方面均有显著改善,而在残疾和感知到的HCV相关问题方面则有所恶化。干预组在各项结果上没有差异。
尽管积极干预相对于对照条件并未取得显著改善,但两种条件下均观察到的改善情况值得进一步探索教育和支持作为HCV行为干预潜在重要要素的作用。需要进一步研究以确定教育干预中可能随着时间推移对改善结果有贡献的共同要素。