Hernandez Rosalba, Burrows Brett, Wilund Kenneth, Cohn Michael, Xu Shuo, Moskowitz Judith T
a School of Social Work, University of Illinois at Urbana-Champaign , Urbana , IL , USA.
b Department of Kinesiology & Community Health , University of Illinois at Urbana-Champaign , Urbana , IL , USA.
Soc Work Health Care. 2018 Nov-Dec;57(10):864-879. doi: 10.1080/00981389.2018.1523268. Epub 2018 Oct 2.
Depression is a pervasive psychological issue facing hemodialysis (HD) patients. Novel technology-based treatment strategies that deploy psychology-based interventions have not been the focus for therapy and few published studies exist. The aim of the current trial is to determine the feasibility and acceptability of an Internet-based positive psychological intervention in HD patients with comorbid depressive symptoms.
HD patients (n = 14) with elevated symptoms of depression were enrolled in a single-arm pre-post trial with clinical assessments at baseline and immediately post intervention. Chairside during regularly scheduled HD treatment, patients utilized a web browser to complete online modules promoting skills for increasing positive emotion over a 5-week period using Apple IPads. Targeted skills included noting of daily positive events, gratitude, positive reappraisal, acts of kindness, and mindfulness/meditation.
Twelve of 14 patients completed the program for an 85.7% retention rate. Participants felt satisfied with each session and offered consistently positive feedback. On average, participants visited the website 3.5 times per week. Significant improvements were evident for depressive symptoms (15.3 vs. 10.9; p = 0.04), as per the Center for Epidemiological Studies Depression Scale.
An innovative Internet-based positive psychological intervention represents a feasible and useful therapeutic option for HD patients with depressive symptoms.
抑郁症是血液透析（HD）患者面临的一个普遍存在的心理问题。基于新技术的治疗策略，即采用基于心理学的干预措施，尚未成为治疗的重点，且发表的相关研究较少。本试验的目的是确定基于互联网的积极心理干预对合并抑郁症状的HD患者的可行性和可接受性。
将14名抑郁症状加重的HD患者纳入一项单组前后对照试验，在基线和干预后立即进行临床评估。在定期安排的HD治疗期间，患者在透析椅旁使用网络浏览器，通过苹果iPad在5周内完成促进增加积极情绪技能的在线模块。目标技能包括记录日常积极事件、感恩、积极重新评价、善举行为以及正念/冥想。
14名患者中有12名完成了该项目，保留率为85.7%。参与者对每一次课程都感到满意，并一直给予积极反馈。参与者平均每周访问该网站3.5次。根据流行病学研究中心抑郁量表，抑郁症状有显著改善（15.3对10.9；p = 0.04）。
一种创新的基于互联网的积极心理干预对有抑郁症状的HD患者来说是一种可行且有用的治疗选择。
