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急性精神科家庭治疗的观察性研究方案:家庭治疗如何发挥作用?确定常见因素和治疗成功的预测因素。

Study protocol of an observational study in acute psychiatric home treatment: How does home treatment work? Identification of common factors and predictors of treatment success.

机构信息

Institute of Psychology, University of Berne, Berne, Switzerland.

GiA Stadt, Lucerne Psychiatry, Voltastr. 42, 6005, Lucerne, Switzerland.

出版信息

Neuropsychiatr. 2023 Dec;37(4):214-220. doi: 10.1007/s40211-023-00457-0. Epub 2023 Mar 20.

Abstract

BACKGROUND

Systematic reviews indicated that home treatment is an effective and cost-saving alternative to conventional acute psychiatric treatment options. Treatment success has often been defined as a reduction of hospital admissions. In the current study, symptoms and well-being are assessed regularly during treatment as an indicator for treatment success. Patients' characteristics such as diagnosis, age, substance use, and motivation for treatment were discussed as predictors for treatment success. A second focal point of the study lies in the examination of the therapeutic relationship in terms of the outcome, which has not yet been systematically investigated in home treatment.

METHODS

This is an observational study with a prospective naturalistic design. Measurements are carried out at baseline, during and at the end of treatment as well as at the 3‑month follow-up. Patients' characteristics as potential predictors for treatment success will be assessed at baseline. In addition, the perceived relationship between the patients and the team will be measured daily and weekly throughout the treatment. Treatment success is by the changes in symptoms and general well-being assessed weekly. We aim to include 82 participants assigned to home treatment. Variance analyses with repeated measurements will be conducted to evaluate treatment success.

CONCLUSION

By examining potential patient- and relationship-related predictors of treatment success, insights into relevant determining variables of treatment success in this setting are expected. The results might help to better identify who benefits the most from home treatment.

摘要

背景

系统评价表明,家庭治疗是一种有效且节省成本的替代传统急性精神科治疗方案的选择。治疗成功通常被定义为住院人数减少。在当前的研究中,在治疗过程中定期评估症状和幸福感,作为治疗成功的指标。还讨论了患者的特征,如诊断、年龄、物质使用和治疗动机,作为治疗成功的预测因素。该研究的第二个重点是从治疗效果的角度考察治疗关系,这在家庭治疗中尚未系统研究过。

方法

这是一项具有前瞻性自然主义设计的观察性研究。在基线、治疗期间和结束时以及 3 个月随访时进行测量。将在基线评估患者特征作为治疗成功的潜在预测因素。此外,在整个治疗过程中,每天和每周都会测量患者与团队之间的感知关系。每周评估症状和总体幸福感的变化来判断治疗成功。我们的目标是纳入 82 名被分配到家庭治疗的参与者。将进行具有重复测量的方差分析,以评估治疗成功。

结论

通过检查治疗成功的潜在患者和关系相关预测因素,有望深入了解该环境中治疗成功的相关决定因素。研究结果可能有助于更好地确定谁最能从家庭治疗中受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f375/10703946/3f54643503c7/40211_2023_457_Fig1_HTML.jpg

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