Web-Based Interactive Multimedia CBT Bereavement Support Program

描述(由申请人提供)：对丧亲的反应可能是个人痛苦的，通常会干扰社会和职业功能。虽然大多数人最终会适应他们的损失，但10%-20%的失去亲人的人会经历重大反应，包括类似于创伤后应激障碍的主要抑郁症状。此外，丧失亲人还会引发其他健康问题。美国每年有400万员工失去亲人，失去亲人给美国企业带来的损失超过445亿美元，原因是医疗利用率增加、缺勤、生产率下降(出勤)以及注意力不集中导致的错误/事故。认知-行为应对技能的教学显示出作为一种减少痛苦和促进社会/职业功能的方法的前景。拟议的基于网络的CBT干预将在一个具有成本效益的多媒体丧亲支持计划中整合和运作流行的悲痛理论。它将把成熟的成人教育和e-Learning教学设计原则与行为改变理论结合起来，以支持亲人去世后的员工。接入将作为员工援助提供商(EAP)和EAP呼叫中心的一项附属服务通过互联网提供。它将根据用户的悲痛背景定制呈现的材料：对死亡的预期、死亡的性质(创伤与自然)，以及与死者的关系是父母还是年长的亲戚、配偶、成年子女、兄弟姐妹、朋友或同事。将通过量身定制的视频推荐信/故事以及多媒体内容演示和自我评估跟踪工具来加强学习和个人支持。完成的计划将提供互动练习和活动，教授认知行为应对技能，重点是：(A)个人悲伤风格；(B)对悲伤的正常反应；(C)身体自我护理；(D)认知行为应对策略；(E)沉思；(F)意义重建；(G)在没有死者的情况下重建身份。此外，该方案将包括满足以下具体需求和支持的模块：(A)人力资源经理；(B)失去亲人的员工的主管；(C)EAP和呼叫中心顾问。第一阶段的原型程序在互联网上的随机试验中显示出显著的效果。第二阶段的产品将针对可通过标准网络浏览器访问的互联网或内联网应用程序进行开发，并将通过大型随机试验进行评估。与公共卫生相关：对丧亲的反应可能是个人痛苦的，通常会干扰社会和职业功能。虽然大多数人最终会适应他们的损失，但10%-20%的失去亲人的人会经历重大反应，包括类似于创伤后应激障碍的主要抑郁症状。此外，丧失亲人还会引发其他健康问题。美国每年有400万员工失去亲人，失去亲人给美国企业带来的损失超过445亿美元，原因是医疗利用率增加、缺勤、生产率下降(出勤)以及注意力不集中导致的错误/事故。

DESCRIPTION (provided by applicant): Reactions to bereavement can be personally painful and typically interfere with social and occupational functioning. While most individuals eventually adapt to their loss, 10-20% of the bereaved experience significant reactions including major depressive symptoms similar to post traumatic stress disorder. Moreover, bereavement can precipitate other health problems. With 4 million employees experiencing the loss of a loved one each year, the cost of bereavement to American business is over $44.5 billion in increased health utilization, absenteeism, reduced productivity (presenteeism), and errors/accidents due to poor concentration. The teaching of cognitive-behavioral coping skills shows promise as a method to decrease distress and promote social/occupational functioning. The proposed Web-based CBT intervention will integrate and operationalize prevailing grief theories in a cost-effective, multimedia bereavement support program. It will incorporate proven adult education and e-Learning instructional design principles with behavioral change theory to support employees following the death of a loved one. Access will be delivered over the Internet as an adjunct service of Employee Assistance Providers (EAP) and EAP Call Centers. It will tailor the presented materials according to the user's grief context: expectedness of the death, the nature of the death (traumatic vs. natural), and whether the relationship to the deceased was that of parent or older relative, spouse, adult child, sibling, friend, or coworker. Learning and personal support will be enhanced with tailored video testimonials/stories, as well as multimedia presentation of content and self-assessment tracking tools. The finished program will offer interactive exercises and activities to teach cognitive-behavioral coping skills that focus on: (a) personal grieving styles; (b) normal reactions to grief; (c) physical self-care; (d) cognitive-behavior coping strategies; (e) rumination; (f) reconstruction of meaning; and (g) reconstruction of identity without the deceased. In addition, the program will include modules to address specific needs and support of: (a) Human Resources Managers; (b) supervisors of bereaved employees; and (c) EAP and Call Center Counselors. The Phase I prototype program showed significant effects in a randomized trial on the Internet. The Phase II product will be developed for Internet or Intranet application accessible via standard web browsers and will be evaluated with a large randomized trial. PUBLIC HEALTH RELEVANCE: Reactions to bereavement can be personally painful and typically interfere with social and occupational functioning. While most individuals eventually adapt to their loss, 10-20% of the bereaved experience significant reactions including major depressive symptoms similar to post traumatic stress disorder. Moreover, bereavement can precipitate other health problems. With 4 million employees experiencing the loss of a loved one each year, the cost of bereavement to American business is over $44.5 billion in increased health utilization, absenteeism, reduced productivity (presenteeism) and errors/accidents due to poor concentration.