远程医疗照护对精神分裂症和双相情感障碍患者的生活质量的影响：一项随机对照试验的结果。
Telemedical care and quality of life in patients with schizophrenia and bipolar disorder: results of a randomized controlled trial.
机构信息
University Hospital Greifswald, Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Ellernholzstraße 1-2, 17487, Greifswald, Germany.
University Hospital Greifswald, Clinic and Polyclinic for Psychiatry and Psychotherapy, Greifswald, Germany.
出版信息
BMC Psychiatry. 2021 Jun 29;21(1):318. doi: 10.1186/s12888-021-03318-8.
BACKGROUND
Schizophrenia and bipolar disorder are serious psychiatric disorders with a high disease burden, a high number of years of life lived with disability and a high risk for relapses and re-hospitalizations. Besides, both diseases are often accompanied with a reduced quality of life (QoL). A low level of quality of life is one predictor for relapses. This study examines whether a telemedical care program can improve QoL.
METHODS
Post stationary telemedical care of patients with severe psychiatric disorders" (Tecla) is a prospective controlled randomized intervention trial to implement and evaluate a telemedical care concept for patients with schizophrenia and bipolar disorder. Participants were randomized to an intervention or a control group. The intervention group received telemedical care including regular, individualized telephone calls and SMS-messages. QoL was measured with the German version of the WHOQOL-BREF. Effects of telemedicine on QoL after 6 months and treatment*time interactions were calculated using linear regressions (GLM and linear mixed models).
RESULTS
One hundred eighteen participants were recruited, thereof 57.6% men (n = 68). Participants were on average 43 years old (SD 13). The treatment*time interaction was not significant. Hence, treatment had no significant effect either. Instead, gender is an influencing factor. Further analysis showed that social support, the GAF-level and QoL-values at baselines were significant determinants for the improvement of QoL.
CONCLUSION
The telemedicine care concept Tecla was not significant for QoL in patients with severe psychiatric disorders. More important for the QoL is the general social support and the level of global functioning of the patients.
TRIAL REGISTRATION
German Clinical Trials Register, DRKS00008548, registered 21 May 2015 - retrospectively registered, https://www.drks.de/drks_web/setLocale_EN.do.
背景
精神分裂症和双相情感障碍是严重的精神疾病，具有较高的疾病负担、大量丧失劳动力的年数以及较高的复发和再住院风险。此外，这两种疾病通常伴随着生活质量（QoL）的下降。生活质量水平低是复发的一个预测因素。本研究旨在探讨远程医疗护理项目是否能提高生活质量。
方法
“严重精神障碍的固定后远程医疗护理”（Tecla）是一项前瞻性对照随机干预试验，旨在实施和评估一种针对精神分裂症和双相情感障碍患者的远程医疗护理概念。参与者被随机分配到干预组或对照组。干预组接受远程医疗护理，包括定期的个性化电话和短信。使用 WHOQOL-BREF 德语版测量生活质量。使用线性回归（GLM 和线性混合模型）计算 6 个月后远程医疗对生活质量的影响和治疗*时间的交互作用。
结果
共招募了 118 名参与者，其中 57.6%为男性（n=68）。参与者的平均年龄为 43 岁（标准差 13 岁）。治疗*时间的交互作用不显著。因此，治疗也没有显著效果。相反，性别是一个影响因素。进一步的分析表明，社会支持、GAF 水平和基线时的 QoL 值是生活质量改善的重要决定因素。
结论
远程医疗护理概念 Tecla 对严重精神障碍患者的生活质量没有显著影响。对生活质量更重要的是患者的一般社会支持和整体功能水平。
试验注册
德国临床试验注册中心，DRKS00008548，注册于 2015 年 5 月 21 日-回顾性注册，https://www.drks.de/drks_web/setLocale_EN.do。
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