电子心理健康：部分或全住院精神病院治疗后儿童和青少年的后续治疗：随机对照 DigiPuR 试验研究方案。

E-Mental-Health aftercare for children and adolescents after partial or full inpatient psychiatric hospitalization: study protocol of the randomized controlled DigiPuR trial.

机构信息

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstrasse 14-16, 72076, Tuebingen, Germany.

PFH - Private University of Applied Sciences, Department of Psychology (Clinical Psychology II), Weender Landstraße 3-7, 37073, Goettingen, Germany.

出版信息

Trials. 2022 Aug 26;23(1):713. doi: 10.1186/s13063-022-06508-1.

DOI:10.1186/s13063-022-06508-1

PMID:36028894

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9412803/

Abstract

BACKGROUND

During reintegration to daily school life following psychiatric hospitalization, children and adolescents are confronted with various challenges and are at risk for rehospitalization. Tailored post-discharge services could support a successful readjustment and accompany the high-risk transition period after discharge. The study DigiPuR ("Digital gestützte Psychotherapie und Reintegration," digitally supported psychotherapy and reintegration) aims to establish and to evaluate an innovative digital aftercare program to alleviate challenges during reintegration and improve cross-sectoral care.

METHODS

DigiPuR is a randomized controlled trial comparing a digital aftercare service with regular aftercare (TAU) (planned N = 150, 25 children/adolescents, 25 parents, and 25 teachers in each group). In the intervention group, direct communication via secure and regular video calls until 8 weeks after discharge and a secure messenger system between the hospital, family, and school, as well as, if needed, external support systems, are established. A longitudinal pre-post-follow-up assessment at admission, discharge, and 8, 24, and 36 weeks after discharge takes place supplemented by a daily smartphone-based ambulatory assessment from a triadic perspective of patients, parents, and teachers. Primary outcomes include whether participants in the intervention group have fewer readmissions and higher treatment satisfaction and health-related quality of life as well as lower symptom severity than participants in the control group.

DISCUSSION

The present study is essential to address the cross-sectoral challenges associated with reintegration into daily (school) life following child and adolescent psychiatric hospitalization and to determine possible needed adaptations in partial or full inpatient settings. If applicability and efficacy of the aftercare service can be demonstrated, integration into regular care will be sought.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04986228 . Registered on August 2, 2021.

摘要

背景

在精神科住院后重新融入日常学校生活期间，儿童和青少年会面临各种挑战，并面临再次住院的风险。量身定制的出院后服务可以支持他们成功调整，并在出院后的高风险过渡期间提供陪伴。该研究 DigiPuR（“数字化支持的心理治疗和再融入”）旨在建立和评估一种创新的数字随访计划，以减轻再融入期间的挑战，并改善跨部门护理。

方法

DigiPuR 是一项随机对照试验，比较数字随访服务与常规随访（TAU）（计划 N = 150，每组 25 名儿童/青少年、25 名父母和 25 名教师）。在干预组中，通过安全且定期的视频通话进行直接沟通，直至出院后 8 周，并建立医院、家庭和学校之间的安全信使系统，以及在需要时，建立外部支持系统。在入院、出院以及出院后 8、24 和 36 周进行纵向的预-后-随访评估，并通过患者、父母和教师三方的每日智能手机基于的动态评估进行补充。主要结局包括干预组的参与者是否比对照组的参与者再次住院率更低、治疗满意度和健康相关生活质量更高、症状严重程度更低。