基于远程医疗的数字认知行为干预治疗外科手术期间的焦虑和抑郁症,用于全膝关节关节整形术
Ata Murat Kaynar1,2,3,4, Nicole Zharichenko1,2, Ajay D Wasan1,2
1Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pennsylvania, USA.
Journal of pain & relief
|October 27, 2023
概括
一个数字认知行为干预计划 (RxWell®) 在接受全膝关节整形手术 (TKA) 的患者中有效减少了手术前的焦虑和抑郁症. 这种干预措施使患者报告的结果正常化,与对照组不同.
科学领域:
- 整形外科手术 整形外科手术
- 数字健康干预措施 数字健康干预措施
- 心理健康在医学中的作用
背景情况:
- 在全膝关节整形术 (TKA) 患者中,手术前的焦虑和抑郁症显著增加了手术后的疼痛和阿片类药物消耗.
- 这些心理因素可以使疼痛和阿片类药物需求增加高达50%.
研究的目的:
- 测试一个基于远程医疗的数字认知行为干预程序 (RxWell®) 可以控制手术前的焦虑和抑郁症的假设.
- 评估RxWell®在正常化TKA手术前患者报告结果测量信息系统 (PROMIS) 焦虑T分的疗效.
主要方法:
- 一项随机对照试验招募了接受初级单边TKA的患者.
- 参与者填写了PROMIS焦虑和抑郁问卷,得分≥57的参与者被随机分配到RxWell®或手术前一个月的对照组.
- 主要结局是RxWell®能够使PROMIS焦虑T分数正常化.
主要成果:
- 在RxWell®组的患者中,焦虑T分数显著下降,从64.3降至58.5 (p=0.006).
- 对照组在焦虑T分数上没有显著变化 (59.4对57.7,p=0.559).
- 在RxWell®组中,抑郁症得分也下降了,尽管在抽象中没有明确详细说明.
结论:
- 该RxWell®计划显示承诺作为一种有效的方法来管理TKA患者的手术前焦虑和抑郁症.
- 远程医疗干预可能是一个可行的解决方案,以减轻心理痛苦对手术结果的负面影响.
- 未经治疗的焦虑水平在手术前一个月内在对照组中保持稳定.
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