Developing an Abuse-Sensitive Depression Care Model

开发对虐待敏感的抑郁症护理模式

• 批准号: 7002316
• 负责人: Christina M Nicolaidis
• 金额: $ 18.13万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-01-01 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7002316
• 关键词: behavioral /social science research tag; belief; clinical research; cognitive behavior therapy; depression; domestic violence; female; group therapy; human subject; human therapy evaluation; model design /development; patient oriented research; preference; primary care physician; psychological models; psychotherapy; spouse abuse; women' s health

DESCRIPTION (provided by applicant): Many studies have documented the value of multi-faceted interventions based on Wagner's Chronic Care Model for treating depression in primary care, but despite a well-known association between depression and intimate partner violence, (IPV) none have focused on the needs of depressed women with histories of IPV. Our long-range goal is to test the effectiveness of an abuse-sensitive chronic care model for depressed women seen in primary care settings. The objective of this proposal is to identify violence-related predictors of adherence and response to an existing multi-faceted depression care intervention, to adapt that model to be more responsive to the needs of abuse survivors, and to assess the feasibility and acceptability of the new abuse-sensitive model in preparation for a large randomized control trial. We hypothesize that women with a history of IPV are less likely to respond to traditional depression treatment models than non-abused women. We further hypothesize that the addition of special abuse-sensitive features such as abuse assessments, referrals to community resources, self-management tools about IPV, and group cognitive behavioral therapy focused on depression and abuse will improve the effectiveness of the chronic care model in treating depression. We propose 3 studies: 1) a prospective cohort study identifying violence related predictors of response to a traditional multi-faceted depression care intervention (care management, psychiatry support, provider education and a depression registry) being implemented by our collaborators; 2) a qualitative needs assessment of depressed IPV survivors to determine their beliefs, needs, treatment barriers and preferences; and 3) a pilot intervention assessing the acceptability and feasibility of an abuse sensitive depression care model. This work is significant, as it will improve our ability to provide mental health services to this challenging group of primary care patients. It is innovative as it applies concepts of chronic care management to an understudied and challenging population. This project will provide the necessary training, experience, and preliminary data for a R01 proposal to conduct a randomized controlled trial testing the effectiveness of an abuse-sensitive depression care model.

描述（由申请人提供）：许多研究已经记录了基于瓦格纳（Wagner）的慢性护理模型来治疗初级保健抑郁症的多面干预措施的价值，但是尽管抑郁症与亲密伴侣暴力之间存在众所周知的关联，（IPV）（IPV）都不集中于抑郁症女性与IPV历史的需求。我们的远程目标是测试对初级保健环境中抑郁症女性的虐待敏感慢性护理模型的有效性。该提案的目的是确定与暴力相关的依从性和对现有多方面抑郁症护理干预措施的反应的预测指标，以适应该模型对虐待幸存者的需求有更大的响应，并评估对大型随机控制试验的新滥用敏感模型的可行性和可接受性。我们假设有IPV史的女性对传统抑郁症治疗模式的反应较小，而不是未虐待的妇女。我们进一步假设，添加对滥用评估，社区资源的推荐，有关IPV的自我管理工具以及专注于抑郁症和虐待的群体认知行为疗法等特殊滥用敏感的特征将提高慢性护理模型在治疗抑郁症方面的有效性。我们提出了3项研究：1）一项前瞻性队列研究，确定了与我们的合作者实施的传统多方面抑郁症护理干预措施（护理管理，精神病学支持，提供者教育和抑郁注册表）的反应相关的预测指标； 2）对抑郁症的IPV幸存者的定性需求评估，以确定其信念，需求，治疗障碍和偏好； 3）试点干预评估虐待敏感抑郁症护理模型的可接受性和可行性。这项工作非常重要，因为它将提高我们为这一充满挑战的初级保健患者提供心理健康服务的能力。它具有创新性，因为它将慢性护理管理的概念应用于研究且充满挑战的人群。该项目将为R01提案提供必要的培训，经验和初步数据，以进行随机对照试验，以测试对虐待敏感的抑郁症护理模型的有效性。