Beintner Ina, Jacobi Corinna
Chair of Clinical Psychology, E-Mental-Health, Technische Universität Dresden, 01062 Dresden, Germany.
Internet Interv. 2019 Jan 14;15:67-75. doi: 10.1016/j.invent.2018.11.004. eCollection 2019 Mar.
Facing poor long-term outcome and high relapse rates in the treatment of bulimia nervosa, we developed an Internet-based aftercare program for women with severe and chronic bulimia nervosa following inpatient treatment based on previous experiences with self-directed targeted prevention and early intervention programs delivered online. The aim of the present study was to examine adherence to the program in detail, to explore potential variables that predict adherence and to analyze whether adherence affects outcomes. We analyzed data from 126 women in the intervention group of a randomized controlled trial. 107 women (85%) logged on to the program platform at least once. These women opened on average 42.8% (SD = 31.9%) of all assigned program pages. Adherence declined during the course of the intervention. Adherence was not associated with the number of outpatient treatment sessions received during the intervention period. Adherence was not related to overall illness severity or duration at baseline. However, excessive exercise at hospital discharge (which may be a sign of insufficient motivation to change eating disorder related behaviors) seems to play some small role in adherence. Adherence did not affect intervention outcomes. Based on our findings, we would like to advocate further research on online aftercare interventions for women with severe and chronic bulimia nervosa.
面对神经性贪食症治疗中较差的长期预后和高复发率，基于以往在线提供的自我导向式针对性预防和早期干预项目的经验，我们为住院治疗后的重度慢性神经性贪食症女性开发了一个基于互联网的后续护理项目。本研究的目的是详细检查对该项目的依从性，探索预测依从性的潜在变量，并分析依从性是否影响治疗结果。我们分析了一项随机对照试验干预组中126名女性的数据。107名女性（85%）至少登录过一次项目平台。这些女性平均打开了所有分配的项目页面的42.8%（标准差=31.9%）。在干预过程中，依从性下降。依从性与干预期间接受的门诊治疗次数无关。依从性与基线时的总体疾病严重程度或病程无关。然而，出院时过度运动（这可能是改变饮食失调相关行为的动机不足的一个迹象）似乎在依从性方面起了一些小作用。依从性并未影响干预结果。基于我们的研究结果，我们提倡对重度慢性神经性贪食症女性的在线后续护理干预进行进一步研究。
