Psychoeducation for HCV and Alcohol Behaviors

HCV 和酒精行为的心理教育

• 批准号: 7034699
• 负责人: CAROL S NORTH
• 金额: $ 61.23万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7034699
• 关键词: alcoholism /alcohol abuse; behavioral /social science research tag; clinical research; clinical trials; coping; education evaluation /planning; family therapy; health education; hepatitis C; hepatitis C virus; high risk behavior /lifestyle; human subject; human therapy evaluation; interview; microorganism disease chemotherapy; patient oriented research; psychopathology; quality of life; questionnaires; social support network; substance abuse related behavior; therapy compliance; virus load

DESCRIPTION (provided by applicant): Medical treatment of hepatitis C (HCV) requires steadfast adherence to be effective, yet physical and psychiatric side effects induced by current medications (interferon and ribavirin) undermine patient motivation and consistency. Barriers to this population's access to vital services, including transportation and insurance and lack of stable housing, pose further threats to optimal management of HCV. Promotion of adherence and patient support may be enhanced if family members and significant others can be enlisted to join HCV providers in this effort. Psychoeducation programs, demonstrated by this team to be effective for patients and families coping with serious mental illness, can have direct relevance and application to HCV. The proposed project will apply a unique, effective family-responsive psychoeducation program (PERF) for HCV, which has not been previously attempted in this population. HCV-PERF will be compared with a didactic education intervention in a randomized controlled trial with 400 HCV patients. The goal is to demonstrate that the intervention will enlarge the eligibility of some patients for HCV treatment and help sustain others through it. The program will provide HCV education and a forum to discuss problems in daily living and coping with the illness in a supportive, proactive, and problem-focused agenda. The topics and issues covered in the psychoeducation groups will emerge from expressed interests of the group members, generating participant-specific discussions emphasizing and reinforcing personalized solutions to the problems of living with a chronic illness and its difficult treatment regimen. This intervention will build on the skills of HCV and mental health professionals with two professionals, one with HCV treatment expertise and the other a with a mental health background, leading the psychoeducation groups. Study participants will be evaluated with several psychospacial/psychiatric measures including coping, functioning, social support, and quality of life as they contemplate or receive standard medical care for HCV. (This research project will not interfere with usual HCV treatment regimens. The problem-solving oriented psychoeducation program is not a replacement for psychiatric care, and psychiatric referrals will be facilitated when appropriate.) Effectiveness of the intervention will be measured through multiple outcome measures, including medical markers such as viral load. This innovative intervention is inexpensive, requires no special equipment or difficult procedures, and can be exported to diverse HCV treatment settings and implemented without extensive training. HCV-PERF has the potential for major positive impact on the HCV population to save lives, reduce costs, and improve medical outcomes.

描述（由申请人提供）：丙型肝炎（HCV）的药物治疗需要坚定地坚持才能有效，但当前药物（干扰素和利巴韦林）引起的身体和精神副作用会损害患者的积极性和一致性。该人群获得交通和保险等重要服务的障碍以及缺乏稳定的住房，对丙型肝炎的最佳管理构成了进一步的威胁。如果可以招募家庭成员和重要其他人加入 HCV 提供者的这一努力，则可以增强依从性和患者支持的促进。该团队证明，心理教育项目对于应对严重精神疾病的患者和家庭是有效的，可以与丙型肝炎病毒直接相关和应用。拟议项目将针对 HCV 应用独特、有效的家庭响应心理教育计划 (PERF)，此前从未在该人群中尝试过该计划。将在一项对 400 名 HCV 患者进行的随机对照试验中将 HCV-PERF 与教学教育干预进行比较。目标是证明干预措施将扩大一些患者接受丙肝病毒治疗的资格，并帮助其他患者维持治疗。该计划将提供丙肝病毒教育和一个论坛，以讨论日常生活中的问题并以支持性、主动性和以问题为中心的议程应对疾病。心理教育小组涵盖的主题和问题将源于小组成员表达的兴趣，产生针对参与者的讨论，强调和加强针对慢性病及其困难治疗方案的生活问题的个性化解决方案。这项干预措施将建立在丙型肝炎和心理健康专业人员的技能基础上，由两名专业人员领导心理教育小组，其中一名具有丙型肝炎治疗专业知识，另一名具有心理健康背景。研究参与者在考虑或接受丙型肝炎标准医疗护理时，将接受多项心理空间/精神病学指标的评估，包括应对、功能、社会支持和生活质量。 （该研究项目不会干扰通常的丙肝治疗方案。以解决问题为导向的心理教育计划不能替代精神科护理，并且将在适当时促进精神科转诊。）干预措施的有效性将通过多种结果措施来衡量，包括病毒载量等医学标记。这种创新干预措施价格低廉，不需要特殊设备或困难的程序，并且可以推广到不同的丙肝治疗机构，无需大量培训即可实施。 HCV-PERF 有可能对 HCV 人群产生重大积极影响，以挽救生命、降低成本和改善医疗结果。