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采用跨诊断心理动力学在线自助干预维持住院身心治疗效果:一项可行性研究的研究方案

Using a transdiagnostic, psychodynamic online self-help intervention to maintain inpatient psychosomatic treatment effects: Study protocol of a feasibility study.

作者信息

Becker Jan, Zwerenz Rüdiger, Johansson Robert, Frederick Ronald J, Andersson Gerhard, Beutel Manfred E

机构信息

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.

Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden.

出版信息

Internet Interv. 2016 Jul 27;5:30-35. doi: 10.1016/j.invent.2016.07.003. eCollection 2016 Sep.

Abstract

BACKGROUND

Online self-help interventions have proven to be effective in treating various specific mental disorders, mainly depression and anxiety. Knowledge regarding their acceptance, efficacy, and usefulness in addition to inpatient or outpatient psychotherapy is limited. Therefore, we plan to evaluate an affect-focused, transdiagnostic, psychodynamic online self-help intervention following inpatient psychotherapy for mixed diagnoses in a feasibility study to determine acceptance, satisfaction, and preliminary estimates of efficacy.

METHODS

The intervention is based on the book "Living Like You Mean It" by Ronald J. Frederick (2009) and the Swedish adaption by Johansson and colleagues (2013). The book was translated into German and thoroughly revised using parts of the Swedish adaption and additional tasks from their intervention. In a pilot phase, corrections concerning comprehensibility of the content and exercises were made based on patient's feedback. In the second step, we developed a website presenting the German adaption in eight units. In the third step, at least  = 66 patients from the Department of Psychosomatic Medicine and Psychotherapy will be recruited for a feasibility study. Patients are randomized into two groups. The intervention group (IG) will receive ten weeks of access to the online self-help intervention together with weekly therapeutic feedback on their progress. The wait-list control group (WLC) will receive access to the intervention for ten weeks as well, but without therapeutic feedback and with a ten-week delay. We will conduct assessments at the beginning of the intervention of the IG (T0), the end of the intervention of the IG (T1), two months later (only IG, T2), and at the end of the intervention of the WLC (T3). The primary outcome is satisfaction with the treatment as measured by the ZUF-8 at T1 and T3 respectively. Secondary outcome measures include emotional competence, depression, anxiety, and quality of life.

CONCLUSION

We expect insight into the usefulness and acceptance of an online self-help intervention used to maintain inpatient treatment effects. Furthermore, we await both groups to benefit from the participation in the intervention. Pre- post and between subject differences will be used as estimate effect sizes to calculate the necessary sample size for a larger efficacy trial.

摘要

背景

在线自助干预已被证明在治疗各种特定精神障碍方面有效,主要是抑郁症和焦虑症。关于其在住院或门诊心理治疗之外的接受度、疗效和实用性的知识有限。因此,我们计划在一项可行性研究中评估一种以情感为重点、跨诊断、心理动力学的在线自助干预措施,该干预措施在住院心理治疗后用于混合诊断,以确定接受度、满意度和疗效的初步估计。

方法

该干预基于罗纳德·J·弗雷德里克(2009年)所著的《像你认真对待生活那样生活》一书以及约翰松及其同事(2013年)的瑞典语改编版。该书被翻译成德语,并使用瑞典语改编版的部分内容和他们干预措施中的其他任务进行了全面修订。在试点阶段,根据患者反馈对内容和练习的可理解性进行了修正。第二步,我们开发了一个网站,以八个单元展示德语改编版。第三步,将从身心医学与心理治疗科招募至少66名患者进行可行性研究。患者被随机分为两组。干预组(IG)将获得为期十周的在线自助干预访问权限,并每周收到关于其进展的治疗反馈。等待名单对照组(WLC)也将获得为期十周的干预访问权限,但没有治疗反馈且延迟十周。我们将在IG干预开始时(T0)、IG干预结束时(T1)、两个月后(仅IG,T2)以及WLC干预结束时(T3)进行评估。主要结果是分别在T1和T3时通过ZUF - 8测量的对治疗的满意度。次要结果指标包括情绪能力、抑郁、焦虑和生活质量。

结论

我们期望深入了解用于维持住院治疗效果的在线自助干预的实用性和接受度。此外,我们期待两组都能从参与干预中受益。前后差异和组间差异将用作效应量估计,以计算更大规模疗效试验所需的样本量。

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