A systematically tested intervention for managing reactive depression.
A systematically tested intervention for managing reactive depression.
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一种经过系统测试的治疗反应性抑郁症的干预措施。
DOI：
10.1097/00006199-200311000-00008
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发表时间：
2003
期刊：
影响因子：
2.5
通讯作者：
Gajewski,ByronJ
中科院分区：
文献类型：
--
作者：
Smith,CarolE;Leenerts,MaryHobbs;Gajewski,ByronJ
患者和家庭照顾者反复经历反应性抑郁症，导致药物错误、慢性疾病管理不善和自我保健能力差。这些问题使他们处于营养不良、感染、心脏病和精神后遗症的高风险中。次要数据分析比较了一系列研究的结果，以评估治疗性写作干预减少反应性抑郁（一种常见且经常复发的不良症状）的可接受性、有效性和成本。方法对系列研究资料进行二次分析。数据来自因非恶性肠道疾病而需要终生每日中心静脉导管输注家庭全肠外营养的患者及其协助这种复杂家庭护理的家庭护理人员。这些研究中结合的变量包括流行病学研究中心抑郁量表（CES-D）的干预前和干预后得分、患者写日记的周数（坚持）以及日记的内容。内容分析用于分析书面资料。将干预材料和护士花费的时间在各研究中取平均值以确定成本。结果各研究中患者（17.94）和护理者（15.75）的加权平均基线CES-D评分显示存在抑郁。在研究中使用日志写作平均10.4周后，两者之间的效应量(d=。27)和within (d=。65)患者组评分显示抑郁症有中度到较大程度的改善。书面日记的主题显示，错过活动、经济担忧、与严重疾病相关的压力以及家庭护理的复杂性与研究中的抑郁症有关。结论该干预措施可被患者接受，治疗反应性抑郁有效，成本低。接下来的步骤将针对干预措施的纵向影响进行测试。
BackgroundPatients and family caregivers repeatedly experience reactive depression that leads to medication errors, mismanagement of chronic disease, and poor self-care. These problems place them at high-risk for malnutrition, infection, heart diseases, and psychiatric sequelae.ObjectivesA secondary data analysis compared findings across a series of studies to evaluate the acceptability, effectiveness, and cost of a therapeutic writing intervention to reduce reactive depression, a common and frequently recurring adverse symptom.MethodsSecondary analysis of data from the series of studies was conducted. Data came from patients requiring lifelong, daily central intravenous catheter infusion of home total parenteral nutrition necessitated by nonmalignant bowel disease and their family caregivers who assist with this complex home care. Variables combined across the studies were pre-and postintervention scores from the Center for Epidemiological Studies-Depression Scale (CES-D), the number of weeks patients wrote in their diaries (adherence), and the written content in the diaries. Content analysis was used to analyze written data. The intervention materials and nurses’ time spent were averaged across studies to determine costs.ResultsThe weighted average baseline CES-D scores across studies for patients (17.94) and caregivers (15.75) showed the presence of depression. After journal writing had been used for an average of 10.4 weeks across studies, the effect sizes of the between (d=. 27) and within (d=. 65) patient group scores indicated moderate to large improvement in depression. Themes from written diaries showed that missing out on activities, financial worries, strain related to the severe illness, and the complexity of home care were related to depression across the studies.ConclusionsThe intervention was acceptable to participants, effective for managing reactive depression, and low in cost. The next steps will address testing for the longitudinal effects of the intervention.