The role of depression and anxiety symptom severity in remotely delivered mental health care.
The role of depression and anxiety symptom severity in remotely delivered mental health care.
复制标题
抑郁和焦虑症状严重程度在远程心理保健中的作用。
DOI：
10.1037/ser0000775
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发表时间：
2024
影响因子：
2.3
通讯作者：
Hogan,JuliannaB
中科院分区：
文献类型：
--
作者：
Ecker,AnthonyH;Amspoker,AmberB;Johnston,Winter;Walder,Annette;Lindsay,JanA;Hogan,JuliannaB
这项研究调查了在COVID-19大流行的初始阶段接受VA视频连接（VVC）或仅音频护理的退伍军人的心理健康特征的差异。确定了一组主要诊断为抑郁症或焦虑症的退伍军人（在2019年3月至2020年2月之间诊断），并获得了2020年4月至12月从事虚拟护理的退伍军人的数据。创建了两组：接受仅音频护理的退伍军人（n= 161，071）和接受两次或两次以上VVC访视的退伍军人（n= 84，505）。多元逻辑回归模型检查了COVID前一年的症状严重程度，作为COVID期间治疗方式的预测因素。卡方检验检验了评估方式与评估次数之间的关联。由九项患者健康问卷和广泛性焦虑症-7评估的症状严重程度显著预测了大流行期间的遭遇模式，因此在COVID-19之前有中度或重度症状的人比症状较轻或无症状的人更有可能在大流行期间遭遇两次或更多次VVC。在接受VVC的患者中，55.62%没有患者健康问卷-9评估，而仅接受音频的患者中有68.96%没有患者健康问卷-9评估。在VVC组中，70.36%的人没有广泛性焦虑症-7评估，而仅音频组为81.02%。综上所述，这些研究结果表明，VVC，与音频相比，在大流行期间被用于接触更严重的心理健康障碍的退伍军人，并参与基于测量的护理管理。
This study examined differences in mental health characteristics of Veterans who received VA Video Connect (VVC) or audio-only care during initial phases of the COVID-19 pandemic. A cohort of Veterans with primary diagnoses of depressive or anxiety disorders (diagnosed between March 2019 and February 2020) was identified, and data were obtained for Veterans who engaged in virtual care from April to December 2020. Two groups were created: Veterans receiving audio-only care (n= 161,071) and Veterans receiving two or more VVC visits (n= 84,505). Multiple logistic regression models examined symptom severity in the year before COVID as a predictor of treatment modality during COVID. Chi-square tests examined associations between modality and the number of assessments. Symptom severity as evaluated by the nine-item Patient Health Questionnaire and Generalized Anxiety Disorder–7 significantly predicted modality of encounters during the pandemic such that those who had moderate or severe symptoms prior to COVID-19 were more likely than those with low or no symptoms to have two or more VVC encounters during the pandemic. Of those who received VVC, 55.62% had no Patient Health Questionnaire–9 assessments compared to 68.96% of those who received audio-only. In the VVC group, 70.36% had no Generalized Anxiety Disorder–7 assessments compared to 81.02% in the audio-only group. Taken together, these findings suggest that VVC, when compared to audio-only, was used during the pandemic to reach Veterans with more severe mental health symptomatology and to engage in administration of measurement-based care.