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增强弱势青少年的复原力与依恋关系:针对有自杀意念的青少年及其照顾者的虚拟小组干预措施的可行性

Building Resilience and Attachment in Vulnerable Adolescents: The Feasibility of a Virtually Delivered Group Intervention for Adolescents with Suicidal Ideation and Their Caregivers.

作者信息

Sheridan Nicole, Kennedy Allison, Gray Clare, Dunn Leigh, Stewart Jayme, Elliott Hannah, Carnrite Kendra, Adeponle Ademola, Cloutier Paula

机构信息

Psychiatry and Mental Health Research, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.

Mental Health, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

出版信息

Telemed Rep. 2024 Feb 13;5(1):36-45. doi: 10.1089/tmr.2023.0056. eCollection 2024.

Abstract

BACKGROUND

The COVID-19 pandemic required many interventions to be conducted virtually. Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a group intervention designed for adolescents and their caregivers to reduce adolescent suicidal ideation (SI).

OBJECTIVE

We aimed to adapt BRAVA for virtual delivery and evaluate its acceptability and feasibility.

METHODS

We conducted an 8-week pre-post trial between October and December 2020. Six adolescents and six primary caregivers were recruited from a pediatric hospital in Ontario, Canada. Families completed a virtual intake and exit assessment together and 6 weekly BRAVA group sessions separately. Satisfaction feedback was collected after each group session and during their exit, and clinical outcomes were collected at intake and exit. Weekly team meetings were conducted to gather clinician feedback.

RESULTS

The study uptake rate was 42.9% of eligible participants. There were no dropouts. Adolescent and caregiver attendance rates for group sessions were high (median = 6). Most youth (83.4%) and caregivers (66.7%) reported that the virtual process worked well. All caregivers (100%) agreed they would participate in a virtual group session again, compared with youth (50%). Providers approved of the virtual adaptation but identified potential improvements (e.g., manual content, safety procedures). Adolescent SI decreased significantly post-treatment ( = 50.7,  = 29.7,  = 0.002).

CONCLUSIONS

Virtual delivery of BRAVA is acceptable and feasible and may help reduce SI in adolescents. Uptake, retention, and satisfaction were high for adolescents and caregivers. Feedback collected will improve BRAVA for future evaluations, including a randomized controlled trial.

摘要

背景

2019冠状病毒病疫情要求许多干预措施以虚拟方式进行。增强弱势青少年的恢复力和依恋感(BRAVA)是一项针对青少年及其照顾者的团体干预措施,旨在减少青少年自杀意念(SI)。

目的

我们旨在对BRAVA进行调整以实现虚拟交付,并评估其可接受性和可行性。

方法

我们在2020年10月至12月期间进行了一项为期8周的前后试验。从加拿大安大略省的一家儿科医院招募了6名青少年和6名主要照顾者。家庭共同完成虚拟的入组和出院评估,并分别参加6次每周一次的BRAVA团体会议。在每次团体会议后和出院时收集满意度反馈,并在入组和出院时收集临床结果。每周召开团队会议以收集临床医生的反馈。

结果

研究参与率为符合条件参与者的42.9%。没有参与者退出。团体会议的青少年和照顾者出席率很高(中位数=6)。大多数青少年(83.4%)和照顾者(66.7%)报告说虚拟过程运行良好。所有照顾者(100%)同意他们会再次参加虚拟团体会议,而青少年的这一比例为50%。提供者认可虚拟调整,但指出了潜在的改进之处(例如,手册内容、安全程序)。青少年自杀意念在治疗后显著下降(=50.7,=29.7,=0.002)。

结论

BRAVA的虚拟交付是可接受且可行的,可能有助于减少青少年的自杀意念。青少年和照顾者的参与度、留存率和满意度都很高。收集到的反馈将改进BRAVA以便未来进行评估,包括随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ddc/10927228/6197c4c2f820/tmr.2023.0056_figure1.jpg

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