Palo Alto Geriatric Research, Education, and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Aging Ment Health. 2021 Oct;25(10):1913-1922. doi: 10.1080/13607863.2020.1758905. Epub 2020 May 13.
This study examined the acceptance, feasibility, and preliminary effects of a guided self-management intervention using video delivery and a telephone coach on anxiety and activity engagement.
Ten Veterans aged 60 years or older with anxiety disorders determined by Structured Clinical Interview for Diagnostic and Statistical Manual 5 edition (SCID-5) at baseline visit participated in this non-randomized study examining a 4-week guided self-management intervention for anxiety. Feasibility was examined using participation engagement with the intervention. Measures of anxiety (Geriatric Anxiety Scale, PROMIS Anxiety Scale, Anxiety Control Questionnaire), depression (Patient Health Questionnaire 9-item), and activity participation (modified Activity Card Sort) administered at baseline and final (week 8) visit provided estimates of preliminary intervention effects. The Geriatric Anxiety Scale also was administered by phone at week 4. Participants completed a semi-structured qualitative interview at the final visit, which provided information about the acceptability, benefits of intervention, and barriers to engagement.
All participants ( = 10) reported that the intervention somewhat or completely met their expectations, demonstrating intervention acceptability. Intervention completers ( = 9) experienced reduced anxiety over the first 4 weeks, alongside significant improvements in anxiety control and personalized activity goals across 8 weeks. However, anxiety symptoms tended to return to baseline at follow-up. Participants identified the relaxation videos and promotion of a daily relaxation routine as the most helpful intervention components.
Findings indicate that the intervention may improve activity participation and reduce anxiety. Thus, guided self-management interventions show promise for reducing distress and maintaining engagement later in life.
本研究考察了使用视频传输和电话辅导员进行的有指导的自我管理干预对焦虑和活动参与的接受度、可行性和初步效果。
10 名年龄在 60 岁及以上的退伍军人在基线就诊时根据诊断和统计手册第 5 版(DSM-5)的结构临床访谈确定患有焦虑障碍,他们参加了这项非随机研究,研究了为期 4 周的焦虑有指导的自我管理干预。通过参与干预来检查可行性。在基线和最终(第 8 周)就诊时,使用焦虑症量表(老年焦虑量表、PROMIS 焦虑量表、焦虑控制问卷)、抑郁(患者健康问卷 9 项)和活动参与(改良活动卡片分类)来衡量初步干预效果。第 4 周还通过电话对老年焦虑量表进行了评估。参与者在最后一次就诊时完成了一项半结构化定性访谈,提供了有关可接受性、干预益处和参与障碍的信息。
所有参与者( = 10)报告说,干预在某种程度上或完全符合他们的预期,表现出可接受性。完成干预的参与者( = 9)在前 4 周内经历了焦虑的减轻,同时在 8 周内焦虑控制和个性化活动目标也有显著改善。然而,焦虑症状在随访时往往会恢复到基线。参与者确定放松视频和促进日常放松常规是最有帮助的干预组成部分。
研究结果表明,该干预可能会改善活动参与度并减轻焦虑。因此,有指导的自我管理干预有望减轻晚年的痛苦并保持参与度。