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基于视频会议的双人小组接受与承诺疗法对慢性心力衰竭患者及其家庭照顾者生活质量的影响:一项随机对照试验研究方案。

Effectiveness of a videoconferencing group-based dyad acceptance and commitment therapy on the quality of life of chronic heart failure patients and their family caregivers: A study protocol for a randomized controlled trial.

机构信息

School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.

出版信息

PLoS One. 2024 Apr 18;19(4):e0298178. doi: 10.1371/journal.pone.0298178. eCollection 2024.

Abstract

BACKGROUND

Chronic heart failure (CHF) poses a significant burden on both patients and their family caregivers (FCs), as it is associated with psychological distress and impaired quality of life (QOL). Acceptance and Commitment Therapy (ACT) supports QOL by focusing on value living and facilitates acceptance of psychological difficulties by cultivating psychological flexibility. A protocol is presented that evaluates the effectiveness of a dyad ACT-based intervention delivered via smartphone on QOL and other related health outcomes compared with CHF education only.

METHODS

This is a single-center, two-armed, single-blinded (rater), randomized controlled trial (RCT). One hundred and sixty dyads of CHF patients and their primary FCs will be recruited from the Cardiology Department of a hospital in China. The dyads will be stratified block randomized to either the intervention group experiencing the ACT-based intervention or the control group receiving CHF education only. Both groups will meet two hours per week for four consecutive weeks in videoconferencing sessions over smartphone. The primary outcomes are the QOL of patients and their FCs. Secondary outcomes include psychological flexibility, psychological symptoms, self-care behavior, and other related outcomes. All outcomes will be measured by blinded outcome assessors at baseline, immediately post-intervention, and at the three-month follow-up. Multilevel modeling will be conducted to assess the effects of the intervention.

DISCUSSION

This study is the first to adopt an ACT-based intervention for CHF patient-caregiver dyads delivered in groups via smartphone. If effective and feasible, the intervention strategy and deliverable approach could be incorporated into clinical policies and guidelines to support families with CHF without geographic and time constraints.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04917159. Registered on 08 June 2021.

摘要

背景

慢性心力衰竭(CHF)给患者及其主要照顾者(FCs)带来了重大负担,因为它与心理困扰和生活质量(QOL)受损有关。接受与承诺疗法(ACT)通过关注有价值的生活来支持 QOL,并通过培养心理灵活性来促进对心理困难的接受。提出了一种方案,该方案评估了通过智能手机提供的基于双元 ACT 的干预措施与仅提供 CHF 教育相比对 QOL 和其他相关健康结果的有效性。

方法

这是一项单中心、双臂、单盲(评估者)、随机对照试验(RCT)。将从中国一家医院的心脏病科招募 160 对 CHF 患者及其主要 FC。将双元随机分层分为接受基于 ACT 的干预的干预组或仅接受 CHF 教育的对照组。两组将在智能手机上的视频会议中每周会面两次,连续四周,每次两小时。主要结果是患者及其 FC 的 QOL。次要结果包括心理灵活性、心理症状、自我护理行为和其他相关结果。所有结果都将由盲法结局评估者在基线、干预后立即和三个月随访时进行测量。将进行多层次建模以评估干预的效果。

讨论

这是第一项采用基于 ACT 的干预措施对 CHF 患者-照顾者二元组进行分组并通过智能手机提供的研究。如果有效且可行,干预策略和可交付成果的方法可以纳入临床政策和指南,在没有地理和时间限制的情况下为 CHF 家庭提供支持。

试验注册

ClinicalTrials.gov 标识符:NCT04917159。于 2021 年 6 月 8 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ed9/11025806/fc857b84f28f/pone.0298178.g001.jpg

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