Palo Alto Geriatric Research, Education, and Clinical Center (CEG, BCK, VKM), VA Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences (CEG, KS, SAB), Stanford University School of Medicine, Stanford, CA.
Palo Alto Geriatric Research, Education, and Clinical Center (CEG, BCK, VKM), VA Palo Alto Health Care System, Palo Alto, CA; Pacific Graduate School of Psychology (BCK, VKM), Palo Alto University, Palo Alto, CA.
Am J Geriatr Psychiatry. 2019 May;27(5):514-525. doi: 10.1016/j.jagp.2018.12.018. Epub 2018 Dec 17.
The study's aim was to demonstrate the feasibility and preliminary efficacy of a 4-week video-delivered relaxation program called Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment (BREATHE) for reducing anxiety and increasing activity engagement in older adults with anxiety disorders.
This was an 8-week pilot randomized controlled trial performed as outpatient and self-directed learning at home among 40 community-dwelling adults aged 60years or older who met criteria for an anxiety disorder (generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, or anxiety disorder unspecified). The study looked at the BREATHE intervention compared with a wait list control condition. The primary outcome measure was anxiety symptoms (Geriatric Anxiety Scale). Secondary outcomes included activity engagement (modified Activity Card Sort), depressive symptoms (Patient Health Questionnaire), and somatic symptoms (Somatic Symptom Scale).
In linear mixed-effects models, findings indicated a significant reduction in anxiety symptoms. There was no significant effect of group on activity engagement. Results also showed significant reductions in depressive and somatic symptoms associated with the BREATHE intervention compared with wait list.
Our findings demonstrate feasibility and preliminary efficacy for this brief video-delivered relaxation intervention and suggest that older adults can benefit from technology-delivered interventions with minimal provider contact. Although activity engagement did not improve, lessons learned suggest that targeted coaching around activity goals may help target this outcome.
本研究旨在展示一项名为“在家中环境中进行呼吸、放松和焦虑治疗教育的 4 周视频传递放松计划(BREATHE)”的可行性和初步疗效,该计划可减少焦虑并增加患有焦虑症的老年人的活动参与度。
这是一项为期 8 周的试点随机对照试验,在社区居住的 40 名年龄在 60 岁或以上且符合焦虑症(广泛性焦虑症、社交焦虑症、恐慌症、广场恐惧症或未特指的焦虑症)标准的成年人中进行,作为门诊和在家中的自我指导学习。该研究观察了 BREATHE 干预与等待名单对照组的比较。主要结局测量指标是焦虑症状(老年焦虑量表)。次要结局包括活动参与度(改良活动卡片分类)、抑郁症状(患者健康问卷)和躯体症状(躯体症状量表)。
在线性混合效应模型中,研究结果表明焦虑症状显著减轻。组间对活动参与度没有显著影响。与等待名单相比,BREATHE 干预与抑郁和躯体症状的显著减少相关。
我们的研究结果表明,这种简短的视频传递放松干预措施具有可行性和初步疗效,表明老年人可以从与提供者接触最少的技术提供的干预措施中受益。尽管活动参与度没有提高,但从中学到的经验表明,围绕活动目标进行有针对性的辅导可能有助于针对这一结果。