Stahl Sarah T, Emanuel James, Albert Steven M, Dew Mary Amanda, Schulz Richard, Robbins-Welty Gregg, Reynolds Charles F
Department of Psychiatry, University of Pittsburgh.
Department of Behavioral and Community Health Sciences, University of Pittsburgh.
Contemp Clin Trials Commun. 2017 Dec;8:99-105. doi: 10.1016/j.conctc.2017.09.002. Epub 2017 Sep 14.
Experiencing the death of a spouse during late life is associated with an increased risk of developing debilitating mental health problems. Healthy lifestyle practices, such as regular exercise, healthy eating, and good sleep hygiene are promising strategies to influence the mental health and associated physical symptoms of late-life spousal bereavement.
This paper describes the design and rationale of an intervention development study addressing selective and indicated prevention of depression, anxiety, and/or complicated grief disorder(s) among adults 60 years and older who are grieving the recent loss (within 8 months) of a spouse or partner.
In Phase I, now complete, we developed and standardized behavioral self-monitoring of daily lifestyle choices via an electronic diary (BSM) and the combined BSM + motivational interviewing-based lifestyle coaching (BSM+MI) to be administered to participants grieving the loss of loved one. In Phase II, we have been implementing the interventions in a randomized controlled trial and addressing challenges related to recruitment. Randomization is to one of three cells: BSM, BSM+MI, or an enhanced usual care condition.
Several challenges in implementing our lifestyle interventions to older widow(er)s who are at risk for common mental disorders have been identified. Direct outreach to hospice organizations is an effective way to identify older adults in the early months following spousal death. Results from study may advance the field of grief support and promote a healthy adaptation to widowhood.
在晚年经历配偶死亡与出现使人衰弱的心理健康问题的风险增加有关。健康的生活方式,如定期锻炼、健康饮食和良好的睡眠卫生习惯,是影响晚年丧偶者心理健康及相关身体症状的有前景的策略。
本文描述了一项干预开发研究的设计和基本原理,该研究针对60岁及以上正在为最近(8个月内)失去配偶或伴侣而悲痛的成年人,进行抑郁症、焦虑症和/或复杂性悲伤障碍的选择性和指示性预防。
在现已完成的第一阶段,我们通过电子日记开发并标准化了对日常生活方式选择的行为自我监测(BSM),以及将BSM与基于动机性访谈的生活方式指导相结合(BSM+MI),并将其应用于因失去亲人而悲痛的参与者。在第二阶段,我们一直在一项随机对照试验中实施这些干预措施,并应对与招募相关的挑战。随机分组进入三个组之一:BSM组、BSM+MI组或强化常规护理组。
我们已经确定了在对有常见精神障碍风险的老年丧偶者实施生活方式干预时存在的几个挑战。直接与临终关怀组织联系是在配偶死亡后的最初几个月识别老年人的有效方法。研究结果可能会推动悲伤支持领域的发展,并促进对丧偶的健康适应。