Clinical and cost‐effectiveness of nurse‐led cognitive behavioral group therapy for recovery of self‐esteem among individuals with mental disorders: A single‐group pre‐post study
Clinical and cost‐effectiveness of nurse‐led cognitive behavioral group therapy for recovery of self‐esteem among individuals with mental disorders: A single‐group pre‐post study
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护士主导的认知行为团体疗法恢复精神障碍患者自尊的临床和成本效益：一项单组前后研究
DOI：
10.1111/jjns.12371
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发表时间：
2020
影响因子：
1.7
通讯作者：
Daisuke Furushima
中科院分区：
文献类型：
--
作者：
Hiroko Kunikata;Naoki Yoshinaga;Kensuke Yoshimura;Daisuke Furushima
目的探讨在精神障碍患者的日常护理中加入护士主导的自尊恢复认知行为团体治疗（CBGTRS）项目是否能改善临床结果并降低直接医疗费用。方法本研究采用单组前后设计，招募51名社区精神障碍患者。除常规护理外，参与者每周接受12次由护士进行的CBGTRS治疗。主要结果测量是自尊水平，其他临床结果和直接医疗费用。在干预前（T0）、干预中点（T1）、干预后立即（T2）和干预后3个月（T3）测量临床结果。计算干预前3个月（A0）、干预后3个月（A1）、干预后4-6个月（A2）和干预后7-9个月（A3）的直接医疗费用。结果从T0到T2和T3自尊得分显著提高（p= 0.009, p= 0.009）。分别为006);组内效应量为。49（小）为T0‐T2，和。51（中）为T0‐T3。其他次要临床结果如情绪、认知偏差、整体功能和生活质量也通过T3得到改善（均p< 0.05）。平均总直接医疗费用从A0（49,569.51日元）显著降低到A2和A3（分别为21,845.76日元和25,981.69日元）(p= 0.003和。017年,分别)。结论护士主导的CBGTRS治疗精神障碍是一种潜在的有效方法，可以改善患者的自尊和其他临床结果，并降低直接医疗费用。需要进一步的对照研究来解决本研究的局限性。
AimTo investigate whether the addition of a nurse‐led cognitive behavioral group therapy for recovery of self‐esteem (CBGTRS) program to usual care for individuals with mental disorders can improve clinical outcomes and reduce direct medical costs.MethodsThis study employed single‐group pre‐post design, and recruited 51 community‐dwelling individuals with mental disorders. Participants received 12 weekly CBGTRS sessions by a nurse in addition to usual care. The primary outcome measure was the level of self‐esteem, with other clinical outcomes and direct medical costs. The clinical outcomes were measured at pre‐intervention (T0), intervention midpoint (T1), immediate post‐intervention (T2), and 3 months post‐intervention (T3). Direct medical costs were calculated for 3 months pre‐intervention (A0), 3 months post‐intervention (A1), between 4–6 months post‐intervention (A2), and between 7–9 months post‐intervention (A3).ResultsSelf‐esteem scores were significantly improved from T0 to T2 and T3 (p= .009 and .006, respectively); within‐group effect sizes were .49 (small) for T0‐T2, and .51 (medium) for T0‐T3. Other secondary clinical outcomes for mood, cognitive bias, global functioning, and quality of life were also improved by T3 (allp< .05). The mean total direct medical costs were significantly reduced from A0 (49,569.51 JPY) to A2 and A3 (21,845.76 JPY and 25,981.69 JPY, respectively) (p= .003 and .017, respectively).ConclusionsThe results suggest that nurse‐led CBGTRS for mental disorders is a potentially effective approach in improving self‐esteem and other clinical outcomes, and in reducing direct medical costs. Further controlled studies that address the limitations of this study are required.