Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.
Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.
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DOI：
10.1136/thoraxjnl-2017-211264
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发表时间：
2019-01
期刊：
影响因子：
10
通讯作者：
Porter LS
中科院分区：
文献类型：
--
作者：
Cox CE;Hough CL;Jones DM;Ungar A;Reagan W;Key MD;Gremore T;Olsen MK;Sanders L;Greeson JM;Porter LS
病情严重到需要住进重症监护病房(ICU)的患者通常在出院后出现心理困扰的症状，但很少有有效的治疗方法来满足他们的需求。在两个学术医学中心进行了为期3个月的试验性随机临床试验。接受心肺衰竭治疗的成年(≥18岁)重症监护病房患者在出院后随机接受三种为期一个月的干预措施之一：基于移动应用程序的自我定向正念计划；由治疗师领导的基于电话的正念计划；或基于网络的危重疾病教育计划。在被分配到移动正念(n=31)、电话正念(n=31)或教育(n=18)的80名患者中，66名(83%)完成了研究。对于主要结果，所有参与者的可行性(同意74%，随机化91%，保留83%)、可接受性(平均客户满意度问卷27.6[标准差3.8])和可用性(平均系统可用性得分89.1[SD 11.5])的观察率超过了目标基准。对于二次结果，平均值(和95%可信区间)反映了患者健康问卷抑郁量表(移动设备(−4.8[−6.6，−2.9])、电话(−3.9[−5.6，−2.2])、教育程度(−3.0[−5.3，0.8])在临床上的显著变化；一般焦虑障碍量表(移动−2.1[−3.7，−0.5]，电话−1.6[−3.0，−0.1]，教育−0.6[−2.5，1.3])，创伤后应激量表(移动−2.6[−6.3，1.2]，电话−2.2[−5.6，1.2]，教育−3.5[−8.0，1.0])，患者健康问卷躯体症状量表(移动−5.3[−7.0，−3.7]，电话−3.7[−5.2，2.2]，教育−4.8[−6.8，2.7])。在ICU患者中，出院后启动的移动正念应用程序证明了可行性、可接受性和可用性，并对心理困扰和身体症状产生了类似于治疗师领导的计划的影响。有必要进行更大规模的试验，以正式测试这种方法的有效性。
Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. Pilot randomized clinical trial with 3-month follow up conducted at two academic medical centers. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomized after discharge home to one of three month-long interventions: a self-directed mobile app-based mindfulness program; a therapist-led telephone-based mindfulness program; or a web-based critical illness education program. Among 80 patients allocated to mobile mindfulness (n= 31), telephone mindfulness (n=31), or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomization 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 [standard deviation 3.8]), and usability (mean Systems Usability Score 89.1 [SD 11.5]). For secondary outcomes, mean values (and 95% confidence intervals) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (−4.8 [−6.6, −2.9]), telephone (−3.9 [−5.6, −2.2]), education (−3.0 [−5.3, 0.8]); the Generalized Anxiety Disorder scale (mobile −2.1 [−3.7, −0.5], telephone −1.6 [−3.0, −0.1], education −0.6 [−2.5, 1.3]), the Post-Traumatic Stress Scale (mobile −2.6 [−6.3, 1.2], telephone −2.2 [−5.6, 1.2], education −3.5 [−8.0, 1.0]), and the Patient Health Questionnaire physical symptom scale (mobile −5.3 [−7.0, −3.7], telephone −3.7 [−5.2, 2.2], education −4.8 [−6.8, 2.7]). Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability, and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led program. A larger trial is warranted to formally test the efficacy of this approach.
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影响因子：
8.8
作者：
Huang, Minxuan;Parker, Ann M.;Needham, Dale M.
通讯作者：
Needham, Dale M.
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
10
作者：
Kamdar, Biren B.;Sepulveda, Kristin A.;Needham, Dale M.
通讯作者：
Needham, Dale M.
DOI：
10.1001/jama.2016.2323
发表时间：
2016-03-22
期刊：
JAMA
影响因子：
--
作者：
Cherkin DC;Sherman KJ;Balderson BH;Cook AJ;Anderson ML;Hawkes RJ;Hansen KE;Turner JA
通讯作者：
Turner JA
影响因子：
158.5
作者：
Herridge, MS;Cheung, AM;Slutsky, AS
通讯作者：
Slutsky, AS