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基于互联网的创伤后应激障碍认知行为疗法(i-CBT)的可接受性:一项系统评价

Acceptability of internet-based cognitive behavioural therapy (i-CBT) for post-traumatic stress disorder (PTSD): a systematic review.

作者信息

Simon Natalie, McGillivray Leah, Roberts Neil P, Barawi Kali, Lewis Catrin E, Bisson Jonathan I

机构信息

Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.

Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK.

出版信息

Eur J Psychotraumatol. 2019 Aug 27;10(1):1646092. doi: 10.1080/20008198.2019.1646092. eCollection 2019.

Abstract

: Internet-delivered Cognitive Behavioural Therapy (i-CBT) offers potential as an alternative, accessible, clinically and cost-effective treatment for post-traumatic stress disorder (PTSD), but little is known about its acceptability. : To review the available evidence to understand the acceptability of i-CBT for PTSD. : We undertook a mixed-methods systematic review according to Cochrane Collaboration Guidelines, of randomised controlled trials (RCTs) of i-CBT for adults with PTSD. We examined included studies for measures of acceptability, and possible proxy indicators of acceptability, including dropout rates, which were meta-analysed as risk ratios (RRs). : Ten studies with 720 participants were included. We found i-CBT to be acceptable according to specific acceptability measures, and suggestions for acceptability according to some proxy measures of i-CBT programme usage. There was, however, evidence of greater dropout from i-CBT than waitlist (RR 1.39, CI 1.03-1.88; 8 studies; participants = 585) and no evidence of a difference in dropout between i-CBT and i-non-CBT (RR 2.14, CI 0.97-4.73; participants = 132; 2 studies). : i-CBT appears a potentially acceptable intervention for adults with PTSD. We identified clinical and research questions, including the status of proxy indicators, and call for standardised, consistent treatment acceptability measurement.

摘要

互联网认知行为疗法(i-CBT)有望成为创伤后应激障碍(PTSD)的一种替代、可及、具有临床疗效且具成本效益的治疗方法,但人们对其可接受性知之甚少。

目的

回顾现有证据,以了解i-CBT对PTSD的可接受性。

方法

我们根据Cochrane协作指南,对针对患有PTSD的成年人的i-CBT随机对照试验(RCT)进行了混合方法的系统评价。我们检查纳入研究的可接受性测量指标以及可接受性的可能替代指标,包括脱落率,将其作为风险比(RRs)进行荟萃分析。

结果

纳入了10项研究,共720名参与者。根据特定的可接受性测量指标,我们发现i-CBT是可接受的,并且根据i-CBT项目使用的一些替代指标得出了关于可接受性的建议。然而,有证据表明i-CBT组的脱落率高于等待名单组(RR 1.39,CI 1.03 - 1.88;8项研究;参与者 = 585),且没有证据表明i-CBT组和非i-CBT组在脱落率上存在差异(RR 2.14,CI 0.97 - 4.73;参与者 = 132;2项研究)。

结论

i-CBT似乎是对患有PTSD的成年人潜在可接受的干预措施。我们确定了临床和研究问题,包括替代指标的状况,并呼吁进行标准化、一致的治疗可接受性测量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4ef/6719262/44ad258f4322/ZEPT_A_1646092_F0001_B.jpg

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