Kılıç Ayşenur, Hudson Joanna, Scott Whitney, McCracken Lance M, Hackett Ruth A, Hughes Lyndsay D
School of Pharmacy, University College London, London WC1H 9JP, UK.
Department of Psychology, King's College London, London SE1 9RT, UK.
Internet Interv. 2023 Aug 8;33:100658. doi: 10.1016/j.invent.2023.100658. eCollection 2023 Sep.
This study explored the feasibility and acceptability of conducting a larger trial of a self-guided, online self-compassion and acceptance and commitment therapy (ACT) focused treatment among people with type 2 diabetes (T2D) to decrease psychological distress.
This study was a two-arm, parallel, feasibility randomised controlled trial with nested qualitative methods. UK adults with T2D were randomly (1:1) allocated to a five-week online self-compassion and ACT treatment or waitlist control. Information regarding recruitment, trial retention, and treatment completion was collected, and post-treatment semi-structured interviews were conducted to assess feasibility and acceptability. Self-report measures of psychological distress (depression, anxiety, diabetes distress) and potential treatment processes (self-compassion and psychological flexibility) were completed as secondary feasibility outcomes.
Fifty-five (60.44 %) out of 91 people who accessed the study link were eligible to participate. Of these, 33 eligible participants (60 %) were randomly assigned to treatment ( = 19) or control arms (waitlist; = 14). While treatment completion was 47.37 %, trial retention rates were 39.39 % (5-week follow-up) and 21.2 % (9-week follow-up). Secondary feasibility outcomes of treatment effect estimates are difficult to interpret in light of low treatment completion and trial retention rates.
A larger trial of the self-guided, online self-compassion treatment to decrease psychological distress in people with T2D may be beneficial, but it has limited feasibility in its current form. Further efforts are needed to improve treatment acceptability of online self-compassion and ACT focused treatment and trial procedures.
本研究探讨了针对2型糖尿病（T2D）患者开展一项更大规模的自我引导式在线自我同情、接纳与承诺疗法（ACT）重点治疗试验以减轻心理困扰的可行性和可接受性。
本研究为一项双臂平行可行性随机对照试验，并采用了嵌套式定性方法。英国成年T2D患者被随机（1:1）分配至为期五周的在线自我同情与ACT治疗组或等待名单对照组。收集了有关招募、试验保留率和治疗完成情况的信息，并进行了治疗后半结构化访谈以评估可行性和可接受性。作为次要可行性结果，完成了心理困扰（抑郁、焦虑、糖尿病困扰）和潜在治疗过程（自我同情和心理灵活性）的自我报告测量。
91名访问研究链接的人中，55人（60.44%）符合参与条件。其中，33名符合条件的参与者（60%）被随机分配至治疗组（n = 19）或对照组（等待名单；n = 14）。虽然治疗完成率为47.37%，但试验保留率在5周随访时为39.39%，在9周随访时为21.2%。鉴于治疗完成率和试验保留率较低，治疗效果估计的次要可行性结果难以解释。
开展一项更大规模的自我引导式在线自我同情治疗以减轻T2D患者心理困扰的试验可能是有益的，但目前形式下可行性有限。需要进一步努力提高在线自我同情和ACT重点治疗的治疗可接受性以及试验程序。
