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一项关于室内环境或慢性疲劳相关持续性身体症状的随机对照试验方案:基于视频的功能性病例概念化和网络程序对改善生活质量的有效性。

A randomized controlled trial protocol for persistent physical symptoms associated with indoor environment or chronic fatigue: Effectiveness of video-based functional case conceptualization and web-program for improving quality of life.

作者信息

Selinheimo Sanna, Keinonen Katariina, Vuokko Aki, Liesto Sanna, Sainio Markku, Lappalainen Raimo, Paunio Tiina

机构信息

Finnish Institute of Occupational Health, Helsinki, Finland.

Outpatient Clinic for Functional Disorders, HUS Helsinki University Hospital, Helsinki, Finland.

出版信息

Front Psychol. 2023 Jan 6;13:923532. doi: 10.3389/fpsyg.2022.923532. eCollection 2022.

Abstract

INTRODUCTION

Persistent physical symptoms (PPS) refer to symptoms that cannot be fully explained by structural bodily pathology or by environmental factors. Their impact on daily functioning varies from mild to severe disability. So far, evidence-based treatments for PPS have resulted in only small to moderate effects. Treatment protocols with a stronger orientation toward personalized approaches are needed to improve the efficacy and applicability of treatment. In this study, we aim to assess the effect of an online individual case conceptualization with web-based program for PPS. This study is conducted among two focus groups: patients with indoor air-related symptoms and patients with chronic fatigue syndrome.

METHODS AND ANALYSES

Using a randomized controlled design (RCT) with two parallel groups in a 1:1 ratio, we will compare individual video-based case conceptualization with a web-based program based on Acceptance and Commitment Therapy (ACT), combined with treatment as usual, with treatment as usual only. The web-based program consists of ten modules, each lasting 1 week and including training. The planned sample size is 124 eligible patients without attrition. The primary outcome will be the health-related quality of life as measured by the 15D questionnaire. The secondary outcome measures will include questionnaires on psychiatric and physical symptoms, illness perceptions, psychological flexibility, and work ability. We will also use national registers to obtain information on the use of healthcare and social benefits to complete patient-reported outcomes. Data collection began in August 2020 and will continue until 2023.

DISCUSSION

This trial will provide information on the effects and usefulness of an online administrated individual case conceptualization and an ACT-based web-program on PPS.

ETHICS AND DISSEMINATION

The Ethics Committee of the Hospital District of Helsinki and Uusimaa, Finland, has granted approval for the study. The results will be published in peer-reviewed journals.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.gov, identifier NCT04532827 preresults.

摘要

引言

持续性躯体症状(PPS)是指无法通过身体结构病理学或环境因素完全解释的症状。它们对日常功能的影响从轻度到严重残疾不等。到目前为止,基于证据的PPS治疗仅产生了小到中等程度的效果。需要更加强调个性化方法的治疗方案来提高治疗的有效性和适用性。在本研究中,我们旨在评估针对PPS的基于网络程序的在线个体病例概念化的效果。本研究在两个焦点组中进行:有室内空气相关症状的患者和慢性疲劳综合征患者。

方法与分析

采用随机对照设计(RCT),分为两个平行组,比例为1:1,我们将基于接受与承诺疗法(ACT)的基于网络的程序结合常规治疗的个体视频病例概念化与仅常规治疗进行比较。基于网络的程序由十个模块组成,每个模块持续1周并包括培训。计划样本量为124名无损耗的合格患者。主要结局将是通过15D问卷测量的健康相关生活质量。次要结局指标将包括关于精神和躯体症状、疾病认知、心理灵活性和工作能力的问卷。我们还将使用国家登记册获取有关医疗保健和社会福利使用情况的信息,以完成患者报告的结局。数据收集于2020年8月开始,并将持续到2023年。

讨论

本试验将提供有关在线管理的个体病例概念化和基于ACT的网络程序对PPS 的效果和有用性的信息。

伦理与传播

芬兰赫尔辛基和新地区医院区伦理委员会已批准该研究。结果将发表在同行评审期刊上。

临床试验注册

Clinicaltrials.gov,标识符NCT04532827预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb5/9853541/d32b32cfae8d/fpsyg-13-923532-g001.jpg

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