对类风湿性关节炎患者心理健康采用非治疗师辅助的基于互联网的认知行为疗法（iCBT）干预措施的支持。
Support for a non-therapist assisted, Internet-based cognitive-behavioral therapy (iCBT) intervention for mental health in rheumatoid arthritis patients.
作者信息
Blaney Caitlin, Hitchon Carol A, Marrie Ruth Ann, Mackenzie Corey, Holens Pamela, El-Gabalawy Renée
机构信息
Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, 671 William Avenue, Winnipeg, Manitoba R3E 0Z2, Canada.
出版信息
Internet Interv. 2021 Mar 26;24:100385. doi: 10.1016/j.invent.2021.100385. eCollection 2021 Apr.
BACKGROUND
Anxiety is common in patients with rheumatoid arthritis (RA) and associated with worse RA outcomes. This study assessed the feasibility and preliminary health impacts (mental and physical) of a non-therapist assisted, online mental health intervention targeting anxiety in this population.
METHODS
Participants with confirmed RA and elevated anxiety symptoms were enrolled into the Worry and Sadness program, an Internet-based cognitive-behavioral therapy (iCBT) intervention for anxiety and depression shown to be effective in the general population. Validated self-report measures of anxiety, depression, pain interference, fatigue, physical health-related quality of life, functional status, and patient-reported disease severity were collected at baseline, post-intervention, and at three-month follow-up. Emotional distress scores were tracked between lessons. Participants provided qualitative feedback in writing post-intervention.
RESULTS
We analyzed the responses of 34 participants; the majority was female (86%) and the mean age was 57 (SD = 13). Of these, 80% ( = 28) completed the study in its entirety. Among these completers, 94.1% described the program as worthwhile. We found statistically significant improvements in anxiety, depression and fatigue from baseline to three-month follow-up, with small to large effect sizes ( = 0.39-0.81). Post-hoc analyses revealed that statistically significant change occurred between baseline and post-intervention for anxiety and depression and was maintained at three-month follow-up, whereas statistically significant change occurred between baseline and three-month follow-up for fatigue. Statistically significant reductions in emotional distress occurred across the program, with a large effect size ( = 1.16) between the first and last lesson.
CONCLUSION
The Worry and Sadness program shows promise as a feasible resource for improving mental health in RA.
背景
焦虑在类风湿关节炎（RA）患者中很常见，且与更差的RA病情转归相关。本研究评估了一种针对该人群焦虑的、非治疗师辅助的在线心理健康干预措施的可行性以及对健康（心理和身体方面）的初步影响。
方法
确诊为RA且焦虑症状加重的参与者被纳入“担忧与悲伤”项目，这是一种基于互联网的认知行为疗法（iCBT）干预措施，用于治疗焦虑和抑郁，已证明在普通人群中有效。在基线、干预后和三个月随访时收集焦虑、抑郁、疼痛干扰、疲劳、与身体健康相关的生活质量、功能状态以及患者报告的疾病严重程度的有效自评指标。在课程之间跟踪情绪困扰评分。参与者在干预后以书面形式提供定性反馈。
结果
我们分析了34名参与者的回复；大多数为女性（86%），平均年龄为57岁（标准差 = 13）。其中，80%（n = 28）完整完成了研究。在这些完成者中，94.1%将该项目描述为有价值。我们发现从基线到三个月随访时，焦虑、抑郁和疲劳有统计学上的显著改善，效应大小为小到中等（Cohen's d = 0.39 - 0.81）。事后分析显示，焦虑和抑郁在基线和干预后之间发生了统计学上的显著变化，并在三个月随访时保持，而疲劳在基线和三个月随访之间发生了统计学上的显著变化。整个项目中情绪困扰有统计学上的显著降低，第一课和最后一课之间的效应大小较大（Cohen's d = 1.
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