Rationale and design: telepsychology service delivery for depressed elderly veterans.
Rationale and design: telepsychology service delivery for depressed elderly veterans.
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基本原理和设计：为抑郁的老年退伍军人提供远程心理学服务。
DOI：
10.1186/1745-6215-10-22
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发表时间：
2009-04-20
期刊：
影响因子：
2.5
通讯作者：
Lejuez C
中科院分区：
文献类型：
--
作者：
Egede LE;Frueh CB;Richardson LK;Acierno R;Mauldin PD;Knapp RG;Lejuez C
生活在农村地区的老年人在健康状况和获得精神卫生保健方面存在显著差异。“远程心理学”（也称为“远程精神病学”或“远程健康”）是解决这一长期问题的潜在战略。老年人可能受益于远程心理学，因为它：（1）有助于解决农村居民目前难以获得护理的问题;（2）能够减少与传统精神卫生保健相关的耻辱感;（3）有助于克服与年龄有关的重大问题。此外，初步证据表明，远程精神病学项目通常对患者来说更便宜，并减少了旅行时间，旅行成本和工作时间。因此，远程心理学可能为农村地区获得保健的问题提供一种具有成本效益的解决办法。我们描述了一项正在进行的为期四年的前瞻性随机临床试验，比较了经验支持的治疗重度抑郁症的有效性，行为激活，通过家庭视频会议技术（“远程心理学”）或传统的面对面服务（“同一个房间”）。我们的假设是，在homeTelepsychology服务提供将是同样有效的传统模式（同室）。224名男性和女性老年受试者将在8周内接受方案驱动的个体行为激活疗法治疗抑郁症;受试者将接受12个月的随访，以确定治疗对三个结局领域的长期影响：（1）临床结局（2）过程变量（患者满意度、治疗可信度、出勤率、依从性、辍学率）;（3）经济结果（成本和资源使用）。从拟议的研究结果将提供重要的洞察远程心理学服务提供是否是有效的传统模式的服务提供，定义在临床，过程和经济成果，老年抑郁症患者居住在农村地区没有足够的精神卫生服务。美国国立卫生研究院临床试验登记处（ClinicalTrials.gov标识符#NCT 00324701）。
Older adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health") represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1) utility to address existing problematic access to care for rural residents; (2) capacity to reduce stigma associated with traditional mental health care; and (3) utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas. We describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology") or traditional face-to-face services ("Same-Room"). Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room). Two-hundred twenty-four (224) male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1) clinical outcomes (symptom severity, social functioning); (2) process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout); and (3) economic outcomes (cost and resource use). Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective as the traditional mode of service delivery, defined in terms of clinical, process, and economic outcomes, for elderly patients with depression residing in rural areas without adequate access to mental health services. National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00324701).
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DOI：
10.1089/153056204773644535
发表时间：
2004-03-01
期刊：
TELEMEDICINE JOURNAL AND E-HEALTH
影响因子：
--
作者：
Bouchard, S;Paquin, B;Lapierre, J
通讯作者：
Lapierre, J
影响因子：
4.7
作者：
Frueh, BC;Henderson, S;Myrick, H
通讯作者：
Myrick, H
影响因子：
5.7
作者：
Fortney, John C.;Pyne, Jeffrey M.;Henderson, Kathy L.
通讯作者：
Henderson, Kathy L.
影响因子：
4.7
作者：
Frueh, B. Christopher;Monnier, Jeannine;Knapp, Rebecca G.
通讯作者：
Knapp, Rebecca G.
影响因子：
1.3
作者：
Bischoff, RJ;Hollist, CS;Flack, P
通讯作者：
Flack, P