Improving Access to Services with an Intensive Weekend Treatment for Panic

通过周末强化恐慌治疗改善获得服务的机会

• 批准号: 8086559
• 负责人: Ellen Teng
• 金额: --
• 依托单位: MICHAEL E DEBAKEY VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8086559
• 关键词: Administrator; Afghanistan; Aftercare; Ambulatory Care Facilities; Anxiety; Anxiety Disorders; Appointment; Bipolar Disorder; Caring; Clinic; Clinical Trials; Cognitive Therapy; Communities; Complement; Country; Dependence; Diagnosis; Distress; Effectiveness; Effectiveness of Interventions; Emotional; Enrollment; Evidence based intervention; Focus Groups; Foundations; Freedom; Frequencies; Functional disorder; Goals; Health Services Accessibility; Healthcare; Hour; Improve Access; Intervention; Interview; Iraq; Life; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Military Personnel; Panic; Panic Attack; Panic Disorder; Participant; Patients; Persons; Pharmaceutical Preparations; Preparation; Provider; Psychotic Disorders; Quality of life; Research; Rural; Rural Community; Sample Size; Sampling; Schools; Services; Severities; Site; Stigmata; Structure; Substance Addiction; Substance abuse problem; Symptoms; Telephone; Testing; Time; Treatment Protocols; Veterans; Withdrawal; Work; base; evidence base; follow-up; help-seeking behavior; information gathering; innovation; member; novel; operation; primary outcome; programs; psychologic; psychosocial; rural area; satisfaction; social; social stigma; treatment duration

DESCRIPTION (provided by applicant): Anticipated Impacts on Veteran's Healthcare: This study explores an innovative method of delivering cognitive-behavioral treatment for recently returning Veterans who have panic disorder and live in rural communities. The potential impact of this study high, as a brief and intensive weekend intervention for anxiety overcomes many help-seeking barriers inherent in conventional psychosocial treatment approaches currently offered in most VA settings. Project Background: Panic disorder ranks among one of the most debilitating and costly anxiety disorders in the country and is accompanied by a host of distressing physical and psychological symptoms. Consequences of panic include medication and substance abuse/dependence, social and emotional dysfunction, vocational problems, and increased social withdrawal. Research indicates that many U.S. military personnel returning from Iraq and Afghanistan do not seek treatment because of time and financial constraints, inability to access immediate care (particularly those living in rural areas), and stigma associated with mental illness. Unfortunately, standard psychosocial treatments for anxiety disorders require multiple appointments and usually occur during the week when most people are in school or at work, which further contributes to the underutilization of services. Project Objectives: The current project proposes to examine the feasibility of implementing an intensive treatment for returning service members with panic disorder in three rural outpatient clinics. The specific aims are to (1) conduct focus groups with stakeholders to identify potential barriers associated with offering the treatment at each clinic; (2) Adapt the treatment to enhance its fit within existing program structures based on information obtained; and (3) pilot the adapted treatment by offering it over a single weekend at each of the three sites. Project Methods: Three focus groups will be conducted with administrators, providers, and patients at three community based outpatient clinics that serve Veterans living in rural areas. The interviews will focus on gathering information regarding the feasibility of offering an intensive two-day treatment at their facilities, which will be used to adapt the existing treatment protocol. The brief evidence-based intervention consists of two, 6-hour days of treatment and will be offered over a single weekend at each site. The total sample expected across the three sites will be 15 Veterans. The sample will consist of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with a current diagnosis of panic disorder. Persons with substance dependence, psychosis, bipolar disorder and severe depression will be excluded from the study. Assessments will be conducted over the telephone one-week before and after treatment, and include a 3-month follow-up. Effect sizes for the primary outcome variables consisting of frequency and severity of panic attacks will be calculated and analyzed using paired samples t-tests. Treatment satisfaction and quality of life will also be evaluated.

描述（由申请人提供）： 对退伍军人的医疗保健的预期影响：这项研究探讨了一种创新的方法，该方法是为最近有恐慌症和生活在农村社区生活的退伍军人提供认知行为治疗的方法。这项研究的潜在影响很高，因为对焦虑的简短而密集的周末干预克服了许多在大多数VA环境中目前提供的常规心理社会治疗方法中固有的寻求帮助的障碍。项目背景：恐慌症是该国最衰弱和昂贵的焦虑症之一，并伴随着许多令人痛苦的身体和心理症状。恐慌的后​​果包括药物和药物滥用/依赖，社会和情感功能障碍，职业问题以及增加社交戒断。研究表明，许多从伊拉克和阿富汗返回的美国军事人员由于时间和经济限制，无法获得即时护理（尤其是居住在农村地区的人）以及与精神疾病有关的污名，因此不寻求治疗。不幸的是，焦虑症的标准社会心理治疗需要多次任命，通常发生在大多数人在学校或工作中的一周中，这进一步导致服务不足。项目目标：当前的项目建议检查在三个农村门诊诊所中为返回服务成员进行强化治疗的可行性。具体目的是（1）与利益相关者进行焦点小组，以确定与每个诊所提供治疗相关的潜在障碍； （2）根据获得的信息调整治疗以增强其在现有程序结构中的拟合； （3）通过在三个地点的每个地点在一个周末提供适应的治疗，从而驾驶改编的治疗方法。项目方法：将与三个基于社区的门诊诊所的管理员，提供者和患者一起进行三个焦点小组，这些诊所服务于农村地区的退伍军人。访谈将着重于收集有关在其设施中提供深密集的为期两天治疗的可行性的信息，该信息将用于调整现有治疗方案。简短的基于证据的干预措施包括两天，6小时的治疗，并将在每个地点的一个周末提供。这三个地点的预期样本总计为15名退伍军人。样本将包括持久的自由/运营伊拉克自由（OEF/OIF）的经营，当前诊断为恐慌症。该研究将排除具有物质依赖，精神病，躁郁症和严重抑郁症的人。评估将在治疗前后通过电话进行一周，并包括3个月的随访。将使用配对样品t检验计算和分析的主要结果变量的效应大小。治疗满意度和生活质量也将得到评估。