A Pilot Randomized Controlled Trial of the PTSD Coach App Following Motor Vehicle Crash-related Injury.
A Pilot Randomized Controlled Trial of the PTSD Coach App Following Motor Vehicle Crash-related Injury.
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DOI：
10.1111/acem.14000
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发表时间：
2020-11
影响因子：
4.4
通讯作者：
Callaway, Clifton W.
中科院分区：
文献类型：
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作者：
Pacella-LaBarbara, Maria L.;Suffoletto, Brian P.;Kuhn, Eric;Germain, Anne;Jaramillo, Stephany;Repine, Melissa;Callaway, Clifton W.
创伤后应激障碍(PTSD)症状(PTSS)在轻伤后很常见，可能会影响康复。我们试图了解带有自助工具的循证手机应用程序(PTSD Coach)是否有助于改善急诊科(ED)受伤患者急性创伤后的康复。这项初步研究考察了在急性车祸(MVC)患者中使用创伤后应激障碍教练的可行性、可接受性和潜在益处。从2017年9月至2018年9月，我们从美国两个一级创伤中心的急诊室招募了MVC术后24小时内的成年患者。我们随机将受伤的成年人分为创伤后应激障碍教练组(n=33)和照常治疗组(n=31)。我们在登记后1个月(83%保留)和3个月(73%保留)评估创伤后应激障碍症状(PTSS)及相关症状。注册是可行的(74%的合格受试者参与了)，但可用性和参与度较低(67%的人至少使用过一次PTSD Coach，主要是在第一周)；76%的人认为这款应用程序的帮助中等到极高。两组之间在PTSS结果上没有差异。对21名黑人受试者的探索性分析表明，那些处于创伤后应激障碍教练状态的人在3个月时报告的创伤后应激障碍较低(95%CI：−0.30；37.77)，而较高的创伤后应对自我效能(95%CI：−58.20；−3.61)。我们证明了招募急性损伤的ED患者参加基于APP的干预研究的可行性，然而，对于PTSD Coach的可用性和益处，出现了混合的证据。大多数患者使用过这款应用一次，并在满意度和帮助方面给予了好评，但纵向参与度较低。后一项发现可能解释了为什么缺乏对PTSS的整体影响。针对更多有症状的患者以及增加参与和支持功能是否可以提高疗效，还需要进行更多的研究。
Posttraumatic stress disorder (PTSD) symptoms (PTSS) are common after minor injuries and can impair recovery. We sought to understand whether an evidence-based mobile phone application with self-help tools (PTSD Coach) could be useful to improve recovery after acute trauma among injured emergency department (ED) patients. This pilot study examined the feasibility, acceptability and potential benefit of using PTSD Coach among acutely injured motor-vehicle crash (MVC) patients. From September 2017-September 2018, we recruited adult patients within 24 hours post-MVC from the EDs of two Level 1 trauma centers in the United States. We randomly assigned 64 injured adults to either the PTSD Coach (n = 33) or treatment as usual (TAU; n = 31) condition. We assessed PTSD symptoms (PTSS) and associated symptoms at 1-month (83% retained) and 3-months (73% retained) post-enrollment. Enrollment was feasible (74% of eligible subjects participated) but usability and engagement were low (67% used PTSD Coach at least once, primarily in week 1); 76% of those who used it rated the app as moderately to extremely helpful. No differences emerged between groups in PTSS outcomes. Exploratory analyses among Black subjects (n = 21) indicated that those in the PTSD Coach condition (versus TAU) reported marginally lower PTSS (95% CI: −0.30; 37.77) and higher PTSS coping self-efficacy (95%CI: −58.20; −3.61) at 3-months. We demonstrated feasibility to recruit acutely injured ED patients into an app-based intervention study, yet mixed evidence emerged for the usability and benefit of PTSD Coach. Most patients used the app once and rated it favorably in regard to satisfaction with and helpfulness, but longitudinal engagement was low. This latter finding may explain the lack of overall effects on PTSS. Additional research is warranted regarding whether targeting more symptomatic patients and the addition of engagement and support features can improve efficacy.
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影响因子：
3.7
作者：
Edmondson D;Richardson S;Falzon L;Davidson KW;Mills MA;Neria Y
通讯作者：
Neria Y
影响因子：
5.9
作者：
Kuhn, Eric;Kanuri, Nitya;Taylor, C. Barr
通讯作者：
Taylor, C. Barr
影响因子：
4.1
作者：
Fairburn, Christopher G.;Patel, Vikram
通讯作者：
Patel, Vikram
影响因子：
3.3
作者：
Friedman, Matthew J.
通讯作者：
Friedman, Matthew J.
DOI：
10.1097/00005373-197403000-00001
发表时间：
1974-01-01
影响因子：
--
作者：
BAKER, SP;ONEILL, B;LONG, WB
通讯作者：
LONG, WB