混合实施有效性集群的设计,随机对照试验,在服务不足的初级保健机构提供PTSD的书面暴露治疗
Lisa S Meredith1, Eunice C Wong2, Brian P Marx3
1RAND Corporation, Santa Monica, CA, United States of America; VA HSR&D Center for Healthcare Innovation, Implementation & Policy, Sepulveda, CA, United States of America.
Contemporary clinical trials
|January 11, 2024
概括
这项研究将书面暴露疗法 (WET) 整合到初级保健中,改善了服务不足人群中创伤后应激障碍 (PTSD) 的治疗. 这些发现支持WETET.
科学领域:
- 临床心理学 临床心理学
- 初级保健 实施 科学 初级保健 实施 科学
- 心理健康服务研究 心理健康服务研究
背景情况:
- 创伤后应激障碍 (PTSD) 在初级保健中很普遍,但基于证据的心理治疗 (EBP) 面临实施挑战.
- 将简短,有效的PTSD治疗整合到初级保健中,对于改善患者的治疗结果和降低社会成本至关重要.
- 创伤治疗和提高性 (BETTER) 研究的构建经验解决了在初级保健中需要可访问的PTSD干预措施的需求.
研究的目的:
- 评估将书面暴露疗法 (WET) 纳入初级保健协作护理管理 (CoCM) 的有效性.
- 评估WET在联邦合格卫生中心 (FQHC) 的实施可行性.
- 检查影响干预对PTSD和抑郁症症状严重性的影响的调节者和调解者.
主要方法:
- 一个混合实施-有效性,集群随机控制试验,涉及12个FQHCs.
- 患者 (n=60个FQHC) 被随机分配到CoCM加WET (CoCM+WET) 或仅CoCM.
- 数据收集包括PTSD和抑郁症症状严重程度,精神/身体功能,FQHC过程数据,以及在基线,3个月和12个月的员工采访.
主要成果:
- 该研究旨在确定与单独使用CoCM相比,CoCM+WET是否能显著改善PTSD和抑郁症症状严重程度.
- 有效性将通过PTSD和抑郁症得分的变化,以及心理和身体健康功能来衡量.
- 实施结果将通过FQHC流程数据和员工的定性反来评估.
结论:
- 这项研究有可能通过证明在初级保健中提供简短的创伤专注的EBP的有效性,对临床实践产生重大影响.
- 在CoCM中成功整合WET可以改善FQHC中接受护理的服务不足人群的PTSD结果.
- 这项研究旨在建立一个可行和有效的模型,以加强在初级保健机构中提供PTSD治疗.
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