针对接受居家护理的老年人抑郁症的基于互联网的心理治疗干预：参与者体验的定性研究
Internet-Based Psychotherapy Intervention for Depression Among Older Adults Receiving Home Care: Qualitative Study of Participants' Experiences.
作者信息
Xiang Xiaoling, Kayser Jay, Sun Yihang, Himle Joseph
机构信息
School of Social Work, University of Michigan, Ann Arbor, MI, United States.
出版信息
JMIR Aging. 2021 Nov 22;4(4):e27630. doi: 10.2196/27630.
BACKGROUND
Depression is common among homebound older adults. Internet-based cognitive behavioral therapy (iCBT) is a promising but understudied approach for treating depression among older adults with disabilities.
OBJECTIVE
This study aims to understand the experiences of homebound older adults who participated in a pilot feasibility trial of an iCBT for depression.
METHODS
The participants included 21 homebound older adults who participated in a generic iCBT program that was not specifically designed for older adults and 8 home care workers who assisted in the iCBT program. Informants completed semistructured individual interviews, which were transcribed verbatim and analyzed using methods informed by grounded theory. A hierarchical code structure of themes and subthemes was developed after an iterative process of constant comparisons and questionings of the initial codes. The data analysis was conducted by using dedoose, a web app for mixed methods research.
RESULTS
Three themes and various subthemes emerged related to participants' experience of the iCBT intervention, as follows: intervention impact, which involved subthemes related to participants' perceived impact of the intervention; challenges and difficulties, which involved subthemes on the challenges and difficulties that participants experienced in the intervention; and facilitators, which involved subthemes on the factors that facilitated intervention use and engagement.
CONCLUSIONS
iCBT is a promising intervention for homebound older adults experiencing depression. Home care workers reported improved relationships with their clients and that the program did not add a burden to their duties. Future programs should involve accessible technical features and age-adapted content to improve user experience, uptake, and adherence.
TRIAL REGISTRATION
ClinicalTrials.gov NCT04267289; https://clinicaltrials.gov/ct2/show/NCT04267289.
背景
抑郁症在居家的老年人中很常见。基于互联网的认知行为疗法（iCBT）是一种有前景但研究不足的治疗残疾老年人抑郁症的方法。
目的
本研究旨在了解参与iCBT治疗抑郁症试点可行性试验的居家老年人的经历。
方法
参与者包括21名居家老年人，他们参加了一个并非专门为老年人设计的通用iCBT项目，以及8名协助该iCBT项目的家庭护理人员。受访者完成了半结构化的个人访谈，访谈内容逐字记录，并采用扎根理论方法进行分析。在对初始编码进行不断比较和质疑的迭代过程后，形成了主题和子主题的分层编码结构。数据分析使用了dedoose，这是一个用于混合方法研究的网络应用程序。
结果
出现了与参与者iCBT干预体验相关的三个主题和各种子主题，如下：干预影响，涉及与参与者对干预的感知影响相关的子主题；挑战与困难，涉及参与者在干预中遇到的挑战和困难的子主题；促进因素，涉及促进干预使用和参与的因素的子主题。
结论
iCBT是一种治疗患有抑郁症的居家老年人的有前景的干预措施。家庭护理人员报告称与客户的关系有所改善，并且该项目没有增加他们的工作职责。未来的项目应具备易于使用的技术特性和适合年龄的内容，以改善用户体验、接受度和依从性。
试验注册
ClinicalTrials.gov NCT04267289；https://clinicaltrials.gov/ct2/show/NCT04267289 。
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