在线多媒体心理教育干预对 COVID-19 住院患者韧性和感知压力的影响：一项试点集群随机平行对照试验。

The effect of online multimedia psychoeducational interventions on the resilience and perceived stress of hospitalized patients with COVID-19: a pilot cluster randomized parallel-controlled trial.

机构信息

Community Based Psychiatric Care Research Center, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, P.O. Box 713451359, Shiraz, Iran.

Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

BMC Psychiatry. 2021 Feb 11;21(1):93. doi: 10.1186/s12888-021-03085-6.

DOI:10.1186/s12888-021-03085-6

PMID:33573631

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7877318/

Abstract

BACKGROUND

There is evidence suggesting that quarantine might have undesirable psychological impacts on the patients. Therefore, it is important to seek for ways to increase the resilience and alleviate the psychological pressure of the patients who are quarantined due to infection with COVID-19. The present study was conducted to assess an online multimedia psychoeducational intervention regarding the feasibility, adherence, patient satisfaction and effectiveness on resilience and perceived stress of patients hospitalized with confirmed COVID-19.

METHOD

This was a pilot cluster randomized parallel-controlled trial with hospital wards as the units of randomization. Participants in this fully online trial were 50 consecutive patients who were hospitalized in 2 hospitals in Shiraz, after being diagnosed with COVID-19. Before the beginning of the intervention, four inpatient wards inside two of the hospitals were randomly assigned to either intervention or control conditions. All eligible participants in the wards allocated to the intervention condition received online multimedia psychoeducational interventions during the 2 weeks, whilst the patients in the wards allocated to the control condition were offered the opportunity to receive telephone-based psychological counseling if needed. Psychoeducational interventions mainly included cognitive-behavioural techniques, stress management techniques, mindfulness-based stress reduction and positive psychotherapy. The patients were assessed regarding resilience and perceived stress at baseline and after two weeks.

RESULTS

Of 27 patients starting multimedia psychoeducational interventions, 26 (96.29%) completed post-assessments. A high level of adherence (80.76%) and satisfaction (Mean = 29.42; SD = 4.18) with the online multimedia psychoeducational interventions was found. Compared with the control group, the patients who used online multimedia psychoeducational interventions reported greater resilience (Mean = 81.74; Mean = 72.86; adjusted t (46) = 2.10; p = 0.04; CI: 0.39 to 17.38; dppc2 = 0.83) and fewer perceived stress (Mean = 22.15; Mean = 29.45; adjusted t (46) = 2.66; p = 0.01; CI: - 12.81 to - 1.78; dppc2 = - 0.77) after 2 weeks.

DISCUSSION

The findings of the present study provided a successful first attempt at implementing feasible online multimedia psychoeducational interventions to promote resilience and mitigate stress among the patients who were hospitalized due to infection with COVID-19. The present results could help mental health professionals to determine which psychological techniques should be emphasized to promote patients' resilience in the context of COVID-19 disease.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials, IRCT20201001048893N1 . Retrospectively registered, 29 Jan 2021.

摘要

背景

有证据表明，隔离可能会对患者产生不良的心理影响。因此，寻求增加因感染 COVID-19 而被隔离的患者的适应力并减轻其心理压力的方法非常重要。本研究旨在评估一种针对 COVID-19 确诊住院患者的在线多媒体心理教育干预措施的可行性、依从性、患者满意度和对适应力和感知压力的效果。

方法

这是一项以医院病房为单位进行随机分组的试点集群随机对照试验。本完全在线试验的参与者是在设拉子的 2 家医院被诊断出 COVID-19 后住院的 50 名连续患者。在干预开始之前，将 2 家医院内的 4 个住院病房随机分为干预组或对照组。分配到干预组的病房内的所有符合条件的参与者在 2 周内接受在线多媒体心理教育干预，而分配到对照组的病房内的患者如果需要，则有机会接受电话心理咨询。心理教育干预主要包括认知行为技术、压力管理技术、正念减压和积极心理治疗。在基线和 2 周后评估患者的适应力和感知压力。

结果

在开始多媒体心理教育干预的 27 名患者中，有 26 名（96.29%）完成了后期评估。患者对在线多媒体心理教育干预的依从性（80.76%）和满意度（平均值=29.42；标准差=4.18）都很高。与对照组相比，使用在线多媒体心理教育干预的患者报告的适应力更高（平均值=81.74；平均值=72.86；调整后的 t（46）=2.10；p=0.04；CI：0.39 至 17.38；dppc2=0.83），感知压力更小（平均值=22.15；平均值=29.45；调整后的 t（46）=2.66；p=0.01；CI：-12.81 至-1.78；dppc2=-0.77），2 周后。