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卒中后疲劳干预试验 (POSITIF):随机多中心可行性试验。

Post stroke intervention trial in fatigue (POSITIF): Randomised multicentre feasibility trial.

机构信息

Usher institute, University of Edinburgh, Edinburgh, UK.

Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK.

出版信息

Clin Rehabil. 2022 Dec;36(12):1578-1589. doi: 10.1177/02692155221113908. Epub 2022 Jul 21.

Abstract

OBJECTIVE

To test the feasibility of a telephone delivered intervention, informed by cognitive behavioural principles, for post-stroke fatigue, and estimated its effect on fatigue and other outcomes.

DESIGN

Randomised controlled parallel group trial.

SETTING

Three Scottish stroke services.

SUBJECTS

Stroke survivors with fatigue three months to two years post-stroke onset.

INTERVENTIONS

Seven telephone calls (fortnightly then a 'booster session' at 16 weeks) of a manualised intervention, plus information about fatigue, versus information only.

MAIN MEASURES

Feasibility of trial methods, and collected outcome measures (fatigue, mood, anxiety, social participation, quality of life, return to work) just before randomisation, at the end of treatment (four months after randomisation) and at six months after randomisation.

RESULTS

Between October 2018 and January 2020, we invited 886 stroke survivors to participate in postal screening: 188/886 (21%) returned questionnaires and consented, of whom 76/188 (40%) were eligible and returned baseline forms; 64/76 (84%) returned six month follow-up questionnaires. Of the 39 allocated the intervention, 23 (59%) attended at least four sessions. At six months, there were no significant differences between the groups (adjusted mean differences in Fatigue Assessment Scale -0.619 (95% CI -4.9631, 3.694;  = 0.768), the Generalised Anxiety Disorder 7 -0.178 (95% CI -3.823, 3.467,  = 0.92), and the Patient Health Questionnaire -0.247 (95% CI -2.935, 2.442,  = 0.851). There were no between-group differences in quality of life, social participation or return to work.

CONCLUSION

Patients can be recruited to a trial of this design. These data will inform the design of further trials in post-stroke fatigue.

摘要

目的

测试基于认知行为原则的电话干预对中风后疲劳的可行性,并评估其对疲劳和其他结果的影响。

设计

随机对照平行组试验。

设置

苏格兰的三个卒中服务机构。

对象

中风后三个月至两年的疲劳幸存者。

干预

七次电话访谈(每两周一次,然后在 16 周时进行“强化会话”),采用手册化的干预措施,并提供有关疲劳的信息,与仅提供信息进行比较。

主要测量指标

试验方法的可行性,以及在随机分组前、治疗结束时(随机分组后四个月)和随机分组后六个月收集的结局测量指标(疲劳、情绪、焦虑、社会参与、生活质量、重返工作)。

结果

在 2018 年 10 月至 2020 年 1 月期间,我们邀请了 886 名中风幸存者进行邮寄筛查:188/886(21%)返回了问卷并同意参与,其中 188/188(100%)符合条件并返回了基线表格;64/76(84%)返回了六个月的随访问卷。在 76 名被分配到干预组的患者中,有 23 名(59%)至少参加了四节电话访谈。在六个月时,两组之间没有显著差异(疲劳评估量表的调整平均差异为-0.619(95%CI-4.9631,3.694; = 0.768),广泛性焦虑症 7 分的差异为-0.178(95%CI-3.823,3.467, = 0.92),患者健康问卷的差异为-0.247(95%CI-2.935,2.442, = 0.851)。两组在生活质量、社会参与或重返工作方面没有差异。

结论

可以招募到参与这种设计试验的患者。这些数据将为中风后疲劳的进一步试验设计提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545f/9574032/4757aad63c1f/10.1177_02692155221113908-fig1.jpg

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