实施基于视频会议的产后抑郁和焦虑症状对话治疗小组：一项实用性评估。

Implementation of a conversational, videoconferencing-based therapy group for postpartum depression and anxiety symptoms: A pragmatic evaluation.

作者信息

Hussain-Shamsy Neesha, Wasserman Lori, Slyfield Cook Greer, Macdonald Kaeli, Greene Keisha, Barker Lucy C, Zaheer Juveria, Mukerji Geetha, Vigod Simone N, Seto Emily

机构信息

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

Women's College Hospital, Toronto, Canada.

出版信息

Digit Health. 2024 Aug 5;10:20552076241269630. doi: 10.1177/20552076241269630. eCollection 2024 Jan-Dec.

DOI:10.1177/20552076241269630

PMID:39108253

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11301728/

Abstract

BACKGROUND

Group psychotherapy is an effective treatment for postpartum depressive and anxiety symptoms, and interpersonal connection and support through the group process can aid recovery. Little is known about the implication of the delivery of interpersonally oriented group therapy in this population through videoconferencing.

OBJECTIVE

To pragmatically evaluate the implementation of a conversationally-oriented postpartum videoconferencing psychotherapy group for depression and anxiety within the clinical setting.

METHODS

Over 8 weeks, five to six patients and one therapist facilitator (closed group) meet weekly for 1 hour via a secure videoconferencing platform. We evaluated group adoption metrics for all postpartum videoconferencing psychotherapy groups offered during the evaluation period (October 2021-August 2022), and offered patients the opportunity to complete baseline and post-group quality improvement surveys to evaluate outcomes including acceptability (Satisfaction with Therapist and Therapy Scale-Revised, STTS-R), group process (Group Questionnaire, GQ), and effectiveness (Edinburgh Postnatal Depression Scale, EPDS).

RESULTS

Of 153 patients ( = 26 groups), most (72.5%) attended >70% of group sessions. Of 137 patients ( = 24 groups) who were sent surveys, = 50 (36.5%) completed both baseline and post-group surveys. Mean () ratings were high for acceptability (STTS-R-therapy: 25.0/30 (3.1); STTS-R-therapist: 27.6/30 (2.3)) and group process with GQ ratings of 81.4/91 (7.8) (positive bond), 34.1/56 (3.8) (positive working relationship) and 23.5/63 (4.4) (negative relationship). Patients with probable depression (EPDS ≥ 13) significantly decreased from = 23 (50%) to = 19 (41.3%, < .001), although the absolute score difference was minimal.

DISCUSSION

Videoconferencing-based group therapy can be implemented with a robust group process and acceptability in the postpartum period. Impact on clinical outcomes should be further investigated.

摘要

背景

团体心理治疗是治疗产后抑郁和焦虑症状的有效方法，通过团体过程建立的人际联系和获得的支持有助于康复。对于通过视频会议为这一人群提供人际导向型团体治疗的意义，我们了解得还很少。

目的

在临床环境中，以务实的态度评估以对话为导向的产后视频会议心理治疗团体对抑郁和焦虑的治疗效果。

方法

在8周的时间里，5至6名患者和1名治疗师（封闭团体）通过安全的视频会议平台每周会面1小时。我们评估了评估期间（2021年10月至2022年8月）提供的所有产后视频会议心理治疗团体的团体采用指标，并让患者有机会完成基线和团体治疗后的质量改进调查，以评估结果，包括可接受性（治疗师和治疗满意度量表修订版，STTS-R）、团体过程（团体问卷，GQ）和有效性（爱丁堡产后抑郁量表）。

结果

在153名患者（共26个团体）中，大多数（72.5%）参加了超过70%的团体治疗课程。在137名被发送调查问卷的患者（共24个团体）中，有50名（36.5%）完成了基线和团体治疗后的调查。可接受性的平均评分较高（STTS-R治疗：25.0/30（3.1）；STTS-R治疗师：27.6/30（2.3）），团体过程的GQ评分为81.4/91（7.8）（积极联系）、34.1/56（3.8）（积极工作关系）和23.5/63（4.4）（消极关系）。可能患有抑郁症（爱丁堡产后抑郁量表≥13）的患者从23名（50%）显著减少至19名（41.3%，P<0.001），尽管绝对得分差异很小。