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针对早期精神病青年患者亲属的基于互联网的心理教育与支持项目:首个德语干预措施的结果

Internet-based psychoeducation and support programme for relatives of young people with early psychosis: results of the first German-language intervention.

作者信息

Rus-Calafell Mar, Teismann Tobias, Kullmann Fine, Alatas Dilara, Ballero-Reque Cristina, Holewa Julia, Rüsberg Marilena, Brüne Martin, Paino Mercedes, Schneider Silvia

机构信息

Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany.

German Center of Mental Health (DZPG), Partner Site Bochum/Marburg, Bochum, Germany.

出版信息

Front Psychiatry. 2024 Jan 16;15:1248526. doi: 10.3389/fpsyt.2024.1248526. eCollection 2024.

Abstract

BACKGROUND

International clinical guidelines recommend Family Interventions (FIs) especially for families of people at early stages of psychosis. The German S3 treatment guideline for schizophrenia gives FIs the highest level of clinical recommendation. However, some family relatives have limited access to these services due to health system constrains. Digital interventions have emerged as a solution to overcome this hindered access to evidence-based family interventions.

OBJECTIVE

The present pilot study evaluates the feasibility and potential efficacy of the first German moderated online psychoeducation and support programme (ePSP) for relatives of people with early psychosis, with the additional purpose to improve accessibility and reduce waiting times.

METHODS

A pre-post study was performed. A brief recruitment period was pre-established (10 weeks) to test potential improvement of regular therapy waiting times in Germany. A total of 25 relatives of people with early psychosis were recruited and received the 12-week moderated online intervention. Assessments were conducted at baseline and at post intervention. Acceptance of the intervention and the user's experience were also evaluated at post intervention.

RESULTS

Recruitment, retention rates and qualitative data support the feasibility and acceptability of the ePSP. Significant positive effects of the interventions were found on key therapeutic targets, including both primary outcomes (i.e., perceived stress and beliefs about the illness). Twenty-one participants also completed the open-ended questions of the user experience questionnaire, which yielded three main themes: most important modules, difficulties in using the programme and ways to improve ePSP.

DISCUSSION

These results provide preliminary efficacy estimates for a fully powered RCT to investigate superiority (or equipoise) effects of the ePSP in comparison to the routine face-to-face family therapy groups. This future RCT will also allow further exploration of ePSP to improve access to psychological therapy for relatives of young people with psychosis, also in relation to the new ground-breaking Digital Healthcare Act in Germany.

摘要

背景

国际临床指南推荐家庭干预,特别是针对处于精神病早期阶段患者的家庭。德国精神分裂症S3治疗指南对家庭干预给予了最高级别的临床推荐。然而,由于卫生系统的限制,一些家庭成员获得这些服务的机会有限。数字干预已成为克服这种阻碍获得循证家庭干预的解决方案。

目的

本试点研究评估首个针对早期精神病患者亲属的德国在线适度心理教育与支持项目(ePSP)的可行性和潜在疗效,另外目的是提高可及性并减少等待时间。

方法

进行了一项前后对照研究。预先设定了一个简短的招募期(10周),以测试德国常规治疗等待时间的潜在改善情况。共招募了25名早期精神病患者的亲属,并接受了为期12周的在线适度干预。在基线和干预后进行评估。干预后还评估了对干预的接受度和用户体验。

结果

招募、留存率和定性数据支持了ePSP的可行性和可接受性。在关键治疗靶点上发现了干预的显著积极效果,包括主要结局(即感知压力和对疾病的信念)。21名参与者还完成了用户体验问卷的开放式问题,产生了三个主要主题:最重要的模块、使用该项目的困难以及改进ePSP的方法。

讨论

这些结果为一项充分有力的随机对照试验提供了初步疗效估计,以研究ePSP与常规面对面家庭治疗组相比的优势(或等效)效果。这项未来的随机对照试验还将允许进一步探索ePSP,以改善精神病患者亲属获得心理治疗的机会,这也与德国新的突破性数字医疗法案有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be3/10824940/e153f958425e/fpsyt-15-1248526-g001.jpg

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