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新冠肺炎大流行期间的远程心理健康的效果:结局的倾向评分非劣效性分析。

Effectiveness of telemental health during the COVID-19 pandemic: A propensity score noninferiority analysis of outcomes.

机构信息

PolicyWise for Children and Families.

Department of Counseling Psychology, University of Wisconsin-Madison.

出版信息

Psychotherapy (Chic). 2023 Jun;60(2):231-236. doi: 10.1037/pst0000472. Epub 2023 Feb 27.

Abstract

The COVID-19 pandemic forced governments to implement a range of public health measures that disrupted the personal and professional lives of many, including an abrupt adoption of telemental health services. Using data from a nonprofit counseling practice, we tested whether telemental health services delivered during the pandemic were inferior to face-to-face services delivered prior to the pandemic. We first characterized patients seeking therapy services before and during the pandemic to ascertain whether the demographics and presenting concerns of patients pre- and during COVID-19 differed and found that pandemic patients reported greater anxiety, greater overall distress, were more likely female and not partnered, and earned less than before the pandemic. We used a propensity score matching analysis to account for these differences and investigated whether or not telemental health therapy was inferior to face-to-face therapy. Based on the propensity-matched samples (2,180 patients in each condition), telemental health services were found not to be inferior to in-person services, allaying concerns about the effectiveness of telemental health services delivered during the COVID-19 pandemic. The present study also illustrates the usefulness of propensity matching for examining treatment effects in naturalistic settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

COVID-19 大流行迫使各国政府实施了一系列公共卫生措施,这些措施扰乱了许多人的个人和职业生活,包括突然采用远程心理健康服务。本研究利用一家非营利咨询机构的数据,检验了大流行期间提供的远程心理健康服务是否不如大流行前提供的面对面服务。我们首先对大流行前后寻求治疗服务的患者进行了描述,以确定大流行前和 COVID-19 期间患者的人口统计学特征和主要关注点是否存在差异,并发现大流行患者报告的焦虑程度更高,整体困扰程度更大,更有可能是女性且没有伴侣,并且收入低于大流行前。我们使用倾向评分匹配分析来考虑这些差异,并调查远程心理健康治疗是否不如面对面治疗。基于倾向匹配的样本(每种情况各 2180 名患者),发现远程心理健康服务并不逊于面对面服务,缓解了对 COVID-19 大流行期间提供的远程心理健康服务效果的担忧。本研究还说明了倾向评分匹配在自然环境中检验治疗效果的有用性。

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