van der Veen Sabina, Evans Natalie, Widdershoven Guy, Huisman Martijn
Department of Ethics, Law and Humanities, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, Netherlands.
Faculty of Social Sciences, Institute of Psychology, Health, Medical and Neuropsychology unit, Leiden University, Leiden, Netherlands.
Int J Integr Care. 2024 Aug 5;24(1):12. doi: 10.5334/ijic.8317. eCollection 2024 Jul-Sep.
The BigMove intervention aims to improve the functioning and quality of life of people with physical and mental health conditions via an integrated care approach. This pilot study evaluates the impact of the intervention on self-perceived health (SPH), quality of life (QoL), active coping behaviour, and mental and social functioning.
Data were analysed from N = 457 participants who had been referred to the intervention by their general practitioner (mean age 48.98 years; 76% female). Three patient-reported and one clinician-rated measures were used: SPH, QoL (MANSA), active coping behaviour (UPCC-ACT), mental and social functioning (HoNOS). Pre- and post-intervention measurements (from 2011 to 2018) were compared using paired-samples t-tests. Due to missing data, analyses were conducted with 205-257 participants per completed outcome. Associations with age and sex were assessed using repeated-measures ANOVA. Clinically relevant change was evaluated with the Edwards-Nunnally index and standard error of measurement (SEM) scores.
Post-intervention, there were statistically significant improvements for all outcomes (p < 0.0001) with moderate to large effect sizes ( = 0.41 to 1.02). The observed changes in outcomes can be considered as clinically relevant improvements.
This pilot study provides preliminary evidence that the intervention has positive effects on SPH, QoL, active coping behaviour, and mental and social functioning.
“大行动”干预旨在通过综合护理方法改善身心健康状况患者的功能和生活质量。这项试点研究评估了该干预对自我感知健康（SPH）、生活质量（QoL）、积极应对行为以及心理和社会功能的影响。
对N = 457名由全科医生转介接受该干预的参与者的数据进行了分析（平均年龄48.98岁；76%为女性）。使用了三项患者报告的指标和一项临床医生评定的指标：自我感知健康、生活质量（MANSA）、积极应对行为（UPCC - ACT）、心理和社会功能（HoNOS）。使用配对样本t检验比较干预前后（2011年至2018年）的测量结果。由于存在缺失数据，对每个完整结局的205 - 257名参与者进行了分析。使用重复测量方差分析评估与年龄和性别的关联。使用爱德华兹 - 努纳利指数和测量标准误差（SEM）分数评估临床相关变化。
干预后，所有结局均有统计学显著改善（p < 0.0001），效应大小为中等至较大（= 0.41至1.02）。观察到的结局变化可被视为具有临床意义的改善。
这项试点研究提供了初步证据，表明该干预对自我感知健康、生活质量、积极应对行为以及心理和社会功能有积极影响。
