Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California.
Department of Psychiatry, Santa Clara Valley Medical Center, San Jose, California.
Top Spinal Cord Inj Rehabil. 2022 Fall;28(4):56-67. doi: 10.46292/sci22-00010. Epub 2022 Nov 15.
A substantial proportion of individuals with spinal cord injury (SCI) experience depression, which has been negatively associated with recovery and community participation after injury. Despite significant barriers to seeking and receiving in-person mental health care, little research has focused on the efficacy of telepsychology among individuals with SCI.
To describe the design and implementation of an ongoing single-center, randomized controlled, video-based cognitive behavioral therapy (CBT) intervention among individuals with SCI.
Participants within 1 year of SCI will be randomized 1:1 to intervention or usual care in a 24-week study. Intervention participants will engage in 10 sessions of CBT over 12 weeks with a licensed clinical psychologist, using iPads via Apple FaceTime. Primary outcomes are depressive symptomatology, anxiety, and life satisfaction (as measured by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Satisfaction with Life Scale, respectively) measured at three time points (baseline, 12 weeks, and 24 weeks). These and other measures are also assessed during monthly telephone surveys conducted between primary timepoints.
Recruitment is ongoing. Forty-six participants have been enrolled thus far.
Telepsychology is a convenient, flexible, and effective alternative to traditional in-person services. We anticipate that intervention participants will experience improvements in depressive and anxiety symptoms and will have greater life satisfaction. Telepsychology interventions among individuals with SCI are tasked to maintain participant privacy, provide assistive technology and/or engage caregivers to minimize mobility limitations, and manage risk remotely. Challenges encountered include recruitment during the COVID-19 pandemic. Early intervention on symptoms of psychological morbidity using telepsychology may facilitate greater adaptation following SCI.
相当一部分脊髓损伤 (SCI) 患者会出现抑郁，这与受伤后康复和社区参与度呈负相关。尽管在寻求和接受面对面心理健康护理方面存在重大障碍，但很少有研究关注 SCI 患者的远程心理疗法的效果。
描述一项正在进行的单中心、随机对照、基于视频的认知行为疗法 (CBT) 干预措施在 SCI 患者中的设计和实施情况。
在 SCI 后 1 年内的参与者将被随机分为干预组或常规护理组，进行为期 24 周的研究。干预组参与者将在 12 周内通过 iPad 使用苹果 FaceTime 与持照临床心理学家进行 10 次 CBT。主要结局指标是抑郁症状、焦虑和生活满意度（分别通过患者健康问卷-9、广泛性焦虑障碍-7 和生活满意度量表测量），在三个时间点（基线、12 周和 24 周）进行测量。这些和其他措施也在主要时间点之间进行的每月电话调查中进行评估。
正在招募参与者。迄今为止，已有 46 名参与者入组。
远程心理疗法是传统面对面服务的一种方便、灵活且有效的替代方案。我们预计干预组参与者的抑郁和焦虑症状将得到改善，生活满意度将提高。针对 SCI 患者的远程心理疗法干预措施的任务是维护参与者的隐私，提供辅助技术和/或让照顾者参与，以最大限度地减少行动限制，并远程管理风险。遇到的挑战包括在 COVID-19 大流行期间的招募。使用远程心理疗法早期干预心理病态症状可能会促进 SCI 后的更好适应。
