Department of Medicine, National Jewish Health, 1400 Jackson St., M107D, Denver, CO 80206, USA.
Department of Psychology, University of Colorado Denver, 1200 Larimer St, Denver, CO 80204, USA.
J Cyst Fibros. 2022 Mar;21(2):332-338. doi: 10.1016/j.jcf.2021.07.012. Epub 2021 Aug 5.
Adults with cystic fibrosis (awCF) have higher levels of depression and anxiety than community samples. The Coping and Learning to Manage Stress with CF (CALM) intervention was developed for awCF reporting elevated symptoms of depression or anxiety.
In this pilot study, awCF were randomly assigned to either six telehealth sessions (CALM; n = 15) or treatment-as-usual (TAU; n = 16). Primary outcomes were depression and anxiety. Secondary outcomes were coping self-efficacy and health-related quality of life (HrQOL). Tertiary outcomes were feasibility, acceptability, and satisfaction. Assessments were completed at baseline, post-intervention, and 3-month follow-up. Group differences were examined via independent samples t-tests. Effect size (ES) was calculated via Cohen's d to provide a measure of the magnitude of the treatment effect.
At post-intervention, the CALM group had a lower mean score than the TAU group for depression (medium ES) and anxiety (large ES). The CALM group had higher (i.e., better) mean scores than the TAU group for coping (large ES) and HrQOL domains of Social Functioning (large ES) and Vitality (large ES). Most treatment gains were not sustained at 3-month follow-up. CALM was feasible, requiring <12 min. for setup and scheduling, and allowed seamless participation when hospitalized. Mean scores for acceptability and satisfaction indicated that most participants either agreed or strongly agreed that CALM was acceptable and satisfactory.
CALM shows promise as an intervention to reduce symptoms of depression and anxiety and improve coping and HrQOL. Next steps are to add a booster session and examine CALM via a multi-site RCT.
囊性纤维化（CF）成人患者的抑郁和焦虑水平高于一般人群。针对报告有抑郁或焦虑症状升高的 CF 成人患者，开发了“应对与学习 CF 管理压力（CALM）”干预措施。
在这项初步研究中，将 CF 成人患者随机分配到六次远程医疗会议（CALM；n=15）或常规治疗（TAU；n=16）。主要结局为抑郁和焦虑。次要结局为应对自我效能和健康相关生活质量（HrQOL）。次要结局为可行性、可接受性和满意度。基线、干预后和 3 个月随访时完成评估。采用独立样本 t 检验比较两组间的差异。通过 Cohen's d 计算效应量（ES），以衡量治疗效果的大小。
在干预后，CALM 组的抑郁评分（中等 ES）和焦虑评分（大 ES）均低于 TAU 组。CALM 组的应对评分（大 ES）和社会功能（大 ES）和活力（大 ES）等 HrQOL 领域的评分均高于 TAU 组。大多数治疗效果在 3 个月随访时并未维持。CALM 是可行的，设置和安排所需时间<12 分钟，且当患者住院时允许无缝参与。接受度和满意度的平均得分表明，大多数参与者要么同意要么强烈同意 CALM 是可接受和满意的。
CALM 有望成为一种降低抑郁和焦虑症状、改善应对和 HrQOL 的干预措施。下一步是添加一个强化疗程，并通过多地点 RCT 来检验 CALM。
