Behdinan Tina, Truuvert Annie K, Adekunte Aishat, McCallum Nancy, Vigod Simone N, Butt Aysha, Rojas David, Soklaridis Sophie, Ross Dana C
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Women's College Hospital and Research Institute, Toronto, Canada.
Telemed Rep. 2024 Jul 12;5(1):195-204. doi: 10.1089/tmr.2024.0020. eCollection 2024.
Adults with mental health symptoms stemming from childhood interpersonal trauma require specialized trauma-focused psychological interventions. Limitations in accessing treatment interventions for this population necessitate innovative solutions. This study explored the feasibility of a protocol for a blended e-health psychoeducational treatment intervention for this population called the Trauma PORTAL (Providing Online tRauma Therapy using an Asynchronous Learning platform), combining asynchronous online modules and weekly live virtual group sessions.
From October 2021 to February 2022, this prospective, single-arm study recruited participants who were waitlisted for trauma therapy at an academic hospital. The primary outcome was protocol feasibility, including recruitment, adoption, and intervention acceptability. Secondary outcomes were pre- and post-intervention post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for DSM-5 [PCL-5]), depression/anxiety/stress (Depression and Anxiety Stress Scale [DASS-21]), and emotion regulation (Difficulties in Emotion Regulation Scale [DERS-18]), which were compared using paired -tests and presented as mean differences (MDs) and 95% confidence intervals (CIs).
A total of 66 participants (median age = 37, female = 61) were enrolled, and they completed on average 53.5% of the online modules. There were 51 (77%) participants who completed post-intervention questionnaires. Acceptability was very high, with 49 respondents (98%) reporting that the intervention increased their access to health care. There were reductions from pre- to post-intervention on the PCL-5 (49.1 vs. 36.7, MD -12.4, 95% CI 8.3-16.5), DERS-18 (51.8 vs. 48.8, MD -3.3, 95% CI 0.2-6.4), and DASS-21 (60.1 vs. 50.7, MD -9.4, 95% CI 2.3-16.6).
The Trauma PORTAL intervention was feasible to implement, well-adopted, and highly acceptable in an ambulatory trauma therapy program. The findings show promising evidence for symptom reduction. Further evaluation of the Trauma PORTAL's efficacy in a randomized trial is warranted.
患有源于童年人际创伤的心理健康症状的成年人需要专门针对创伤的心理干预措施。该人群在获得治疗干预方面存在限制，因此需要创新解决方案。本研究探讨了一种混合式电子健康心理教育治疗干预方案对该人群的可行性，该方案称为创伤PORTAL（使用异步学习平台提供在线创伤治疗），它结合了异步在线模块和每周一次的实时虚拟小组会议。
2021年10月至2022年2月，这项前瞻性单臂研究招募了在一家学术医院等待创伤治疗的参与者。主要结果是方案可行性，包括招募、采用和干预可接受性。次要结果是干预前后的创伤后应激障碍（PTSD）症状（《精神疾病诊断与统计手册》第5版创伤后应激障碍检查表[PCL-5]）、抑郁/焦虑/压力（抑郁焦虑压力量表[DASS-21]）和情绪调节（情绪调节困难量表[DERS-18]），使用配对t检验进行比较，并以平均差异（MDs）和95%置信区间（CIs）表示。
共招募了66名参与者（年龄中位数=37岁，女性=61名），他们平均完成了53.5%的在线模块。有51名（77%）参与者完成了干预后的问卷调查。可接受性非常高，49名受访者（98%）报告该干预增加了他们获得医疗保健的机会。干预前后，PCL-5（49.1对36.7，MD -12.4，95%CI 8.3-16.5）、DERS-18（51.8对48.8，MD -3.3，95%CI 0.2-6.4）和DASS-21（60.1对50.7，MD -9.4，95%CI 2.3-16.）均有所降低。
创伤PORTAL干预在门诊创伤治疗项目中实施可行、采用良好且高度可接受。研究结果显示了症状减轻的有力证据。有必要在随机试验中进一步评估创伤PORTAL的疗效。
