Outcomes, feasibility and acceptability of a group support psychotherapeutic intervention for depressed HIV affected Ugandan adults: A pilot study
Outcomes, feasibility and acceptability of a group support psychotherapeutic intervention for depressed HIV affected Ugandan adults: A pilot study
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DOI：
10.1016/j.jad.2014.05.005
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发表时间：
2014-09-01
影响因子：
6.6
通讯作者：
Mills, Edward J.
中科院分区：
文献类型：
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作者：
Nakimuli-Mpungu, Etheldreda;Wamala, Kizito;Mills, Edward J.
背景：心理治疗是轻中度抑郁症的首选治疗方法。然而，它在低资源环境中的可用性是有限的。我们开发了一个手动的文化敏感群体支持心理治疗干预抑郁症艾滋病毒感染乌干达成年人。在本研究中，我们旨在评估其可行性、可接受性及其对抑郁、功能、社会支持和自尊的影响。方法：将77名抑郁症患者分为小组干预组（n = 48）和候补对照组（n = 29），分别在干预前、干预中和干预结束时进行评估。采用自我报告问卷、地方相关功能评估量表、Rosenberg自尊量表和多维感知社会支持量表，分三个评估期对抑郁症状、功能、自尊和社会支持进行评估。使用多变量纵向回归模型来确定两组之间的结果随时间的变化。参与者被要求评估干预措施。结果：干预后评估显示，与等候名单对照组相比，干预组抑郁症状评分下降更快[OR = 0.00,95% CI, 0.00-0.003]，功能评分上升更快[OR = 4.82, 95% CI]。2.39 ~ 9.75]、社会支持评分[OR = 2.68, 95% CI, 1.50 ~ 4.78]和自尊[OR = 1.90, 95% CI 1.48 ~ 244]。百分之六十三的参与者强烈同意干预减轻了他们的抑郁，并将推荐给其他抑郁症患者。局限性：由于样本量小，研究能力不足，即使存在显著差异，也可能导致置信区间不精确。使用非随机样本可能会导致选择偏差。结论：该干预在治疗抑郁症、恢复功能、增强社会支持和自尊方面是可行的、可接受的和有希望的。更大规模的随机评估是有必要的。(C) 2014 Elsevier B.V.版权所有
Background: Psychotherapy is the recommended first line treatment for mild to moderate depression. However, its availability in low resource settings is limited. We developed a manualized culturally sensitive group support psychotherapeutic intervention for depressed HIV affected Ugandan adults. In this study, we aimed to assess its feasibility, acceptability and impact on depression, functioning, social support and self-esteem.Methods: A total of 77 depressed individuals were assigned to the group intervention (n = 48) and a wait-list control group (n = 29), and assessed before, during and at the end of the intervention. The self-reporting questionnaire, a locally relevant function assessment instrument, the Rosenberg self-esteem scale, and the multiple dimensions perceived social support scale were administered to assess depression symptoms, functioning, self-esteem and social support at three assessment periods. Multivariate longitudinal regression models were used to determine change in outcomes over time between the two groups. Participants were asked to evaluate the intervention.Results: Post -intervention assessments indicate that, in comparison to the wait-list control group, the intervention group had a faster reduction in depression symptom scores IOR = 0.00,95% CI, 0.00-0.003] and faster increase in functioning scores [OR = 4.82, 95% CI. 2.39 to 9.75], social support scores [OR = 2.68, 95% CI, 1.50-4.78] and self-esteem [OR = 1.90, 95% CI 1.48-244]. Sixty-three percent of participants strongly agreed that the intervention had reduced their depression and would recommend it to other depressed individuals.Limitations: Inadequate study power due to small sample sizes may result in imprecise confidence intervals even when there are significant differences. The use of non-random samples could have resulted in selection bias.Conclusions: This intervention appears feasible, acceptable and promising in treating depression and restoring function, enhancing social support and self-esteem. Larger and randomized evaluations are warranted. (C) 2014 Elsevier B.V. All rights reserved.