基于同伴提供和技术支持的自我管理干预对老年严重精神障碍患者的可行性、可接受性和初步有效性。
Feasibility, Acceptability, and Preliminary Effectiveness of a Peer-Delivered and Technology Supported Self-Management Intervention for Older Adults with Serious Mental Illness.
机构信息
Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200, Lebanon, NH, 03766, USA.
CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, USA.
出版信息
Psychiatr Q. 2018 Jun;89(2):293-305. doi: 10.1007/s11126-017-9534-7.
To assess the feasibility, acceptability, and preliminary effectiveness of a peer-delivered and technology supported integrated medical and psychiatric self-management intervention for older adults with serious mental illness. Ten older adults with serious mental illness (i.e., schizophrenia, schizoaffective disorder, bipolar disorder, or major depressive disorder) and medical comorbidity (i.e., cardiovascular disease, obesity, diabetes, chronic obstructive pulmonary disease, hypertension, and/or high cholesterol) aged 60 years and older received the PeerTECH intervention in their homes. Three certified peer specialists were trained to deliver PeerTECH. Data were collected at baseline, one-month, and three-month. The pilot study demonstrated that a three-month, peer-delivered and technology-supported integrated medical and psychiatric self-management intervention ("PeerTECH") was experienced by peer specialists and participants as feasible and acceptable. PeerTECH was associated with statistically significant improvements in psychiatric self-management. In addition, pre/post, non-statistically significant improvements were observed in self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment. This pre/post pilot study demonstrated it is possible to train peers to use technology to deliver an integrated psychiatric and medical self-management intervention in a home-based setting to older adults with serious mental illness with fidelity. These findings provide preliminary evidence that a peer-delivered and technology-supported intervention designed to improve medical and psychiatric self-management is feasible, acceptable, and is potentially associated with improvements in psychiatric self-management, self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment with older adults with serious mental illness and chronic health conditions.
评估一项由同伴提供并得到技术支持的、针对有严重精神疾病的老年患者的医学和精神科综合自我管理干预措施的可行性、可接受性和初步效果。10 名患有严重精神疾病（即精神分裂症、分裂情感性障碍、双相情感障碍或重性抑郁障碍）和合并躯体疾病（即心血管疾病、肥胖症、糖尿病、慢性阻塞性肺疾病、高血压和/或高胆固醇血症）的 60 岁及以上老年患者在其家中接受了同伴技术（PeerTECH）干预。三名经过认证的同伴专家接受了提供 PeerTECH 的培训。在基线、一个月和三个月时收集数据。初步研究表明，为期三个月的、由同伴提供并得到技术支持的医学和精神科综合自我管理干预措施（“PeerTECH”），无论是同伴专家还是参与者都认为是可行和可接受的。PeerTECH 与精神科自我管理方面的统计学显著改善相关。此外，自我效能感、希望、生活质量、医学自我管理技能和赋权等方面也观察到了预/后、非统计学显著的改善。这项预/后初步研究表明，有可能对同伴进行培训，使其能够在基于家庭的环境中使用技术来为有严重精神疾病的老年患者提供综合精神科和医学自我管理干预，且具有一定的忠实度。这些发现初步证明了，设计用于改善医学和精神科自我管理的同伴提供和技术支持的干预措施是可行的、可接受的，并且可能与改善精神科自我管理、管理慢性健康状况的自我效能感、希望、生活质量、医学自我管理技能和赋权相关，对象是有严重精神疾病和慢性健康状况的老年患者。
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