Using Telemedicine to Identify Depressive Symptomatology Rating Scale in a Home Parenteral Nutrition Population.
Using Telemedicine to Identify Depressive Symptomatology Rating Scale in a Home Parenteral Nutrition Population.
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DOI：
10.1007/s41347-017-0025-3
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Smith CE
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文献类型：
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作者：
Adams N;Hamilton N;Nelson EL;Smith CE
家庭肠外营养(HPN)是一种终生的每日12小时静脉营养输注疗法，用于纠正因内科住院以外的胃肠道故障导致的营养失衡。使用HPN的患者面临心理社会挑战，特别是抑郁症，由于缺乏与卫生保健专业人员的日常互动，往往没有被发现。远程医疗作为一种治疗模式，可以通过增加患者的可及性来帮助卫生保健专业人员检测抑郁症。因此，在目前的研究中，我们调查了在长期HPN人群中使用远程医疗评估抑郁症状的可行性。我们假设远程医疗将是一种可行的机制，通过这种机制，训练有素的卫生保健专业人员可以监测和识别长期HPN人群中的抑郁症状。评分员使用修改的Raskin量表(21个项目的观察者评定量表；M=33.28，SD=33.46)对25个促进的小组讨论进行编码，并将其与基线(M=97.88，SD=55.46)和4个月(M=776，SD=55.64)的患者健康问卷-9(PHQ-9)进行比较。我们的结果表明，修改后的Raskin量表显示出较差的同时效度，而该量表显示出较强的预测效度。因此，对于希望使用远程医疗作为治疗途径来检测和监测长期HPN患者中的抑郁的卫生保健专业人员来说，改进的Raskin量表显示了作为一种工具的前景。
Home parenteral nutrition (HPN) is a life-long daily 12-h intravenous nutrition infusion therapy that corrects for nutrient imbalances caused by a malfunctioning gastrointestinal tract outside a medical inpatient setting. Patients utilizing HPN face psychosocial challenges, particularly depression, that often goes undetected due to the lack of daily interactions with health care professionals. Telemedicine, as a mode of treatment, can assist health care professionals in the detection of depression by increasing accessibility to patients. Therefore, in the current study, we investigate the feasibility in assessing depressive symptomatology using telemedicine within a long-term HPN population. We hypothesized that telemedicine would be a viable mechanism by which trained health care professionals could monitor and identify depressive symptomatology within the long-term HPN population. Raters coded 25 facilitated group discussions with the modified Raskin scale (a 21-item observer rating scale; M = 3.28, SD = 3.46) and compared it to the Patient Health Questionnaire-9 (PHQ-9) at baseline (M = 7.88, SD = 5.46) and 4 months (M = 7.76, SD = 5.64). Our results suggest that the modified Raskin scale demonstrated evidence of poor concurrent validity the scale displayed strong predictive validity. Thus, the modified Raskin scale showed promise as a tool for health care professionals, who wish to use telemedicine as a treatment avenue to detect and monitor depression among long-term HPN patients.