Developing an Integrative, Recovery-Based, Post-Acute COVID-19 Syndrome (PACS) Psychotherapeutic Intervention

制定综合性、基于恢复的急性后 COVID-19 综合症 (PACS) 心理治疗干预措施

• 批准号: 10683267
• 负责人: Marianne Goodman
• 金额: --
• 依托单位: JAMES J PETERS VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-10-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10683267
• 关键词: Activities of Daily Living; Acute; Address; American; Anxiety; Anxiety Disorders; COVID-19; COVID-19 patient; Cardiovascular system; Caring; Chaplain; Chronic; Climacteric; Clinical; Consultations; Contracts; Coping Skills; Coupled; Data; Development; Disease; Distress; Education; Educational process of instructing; Employment; Epidemiology; Fatigue; Feedback; Fostering; Future; Goals; Headache; Health; High Prevalence; Impairment; Individual; Infection; Intervention; Interview; Knowledge; Leadership; Life; Life Style; Loneliness; Long COVID; Longitudinal Studies; Measures; Medical; Memory impairment; Mental Depression; Mental Health; Mental disorders; Modeling; Needs Assessment; Neurologic; Neurologic Symptoms; Nutritionist; Pain; Pain Disorder; Participant; Patients; Persons; Phase; Population; Post-Traumatic Stress Disorders; Prevalence; Process; Protocols documentation; Provider; Psychological adjustment; Psychotherapy; Quality of life; Recovery; Registries; Rehabilitation therapy; Sampling; Services; Sleep Disorders; Sleeplessness; Specialist; Symptoms; Techniques; Testing; Time; United States; United States Department of Veterans Affairs; United States National Institutes of Health; Veterans; acceptability and feasibility; arm; arthropathies; cohort; common symptom; coping; coronavirus disease; design; empowerment; experience; fitness; flexibility; follow-up; functional disability; functional improvement; functional restoration; functional status; group intervention; health assessment; improved; improvement on sleep; innovation; interdisciplinary approach; intervention refinement; medical schools; novel; optimism; physical conditioning; post SARS-CoV-2 infection; programs; promote resilience; psychosocial; pulmonary symptom; relapse prevention; resilience; satisfaction; skills; skills training; symptomatology; telehealth; therapy development; whole health

Project Abstract At present, 34.6 million people in the United States, and 273,232 Veterans tested or treated in Veteran Affairs facilities contracted COVID-19. While the exact prevalence of Post-Acute COVID-19 Syndrome (PACS) among Veterans is unknown, estimates of psychiatric/neurological PACS using a large global sample of COVID-19 patients (N=236,379) suggest a prevalence of approximately 11,390,400 Americans, and 90,311 Veterans in VA care, with rates likely to increase over time. Moreover, large scale studies suggest up to 35% of individuals experience functional impairment 8 months after COVID-19, and high prevalence of post-infection mental illness including anxiety disorders, depression, and post-traumatic stress disorder. Using longitudinal data from our academic affiliate, Icahn School of Medicine at Mount Sinai’s COVID registry (n≈1200), and local James J. Peters VA’s Clinical PACS program, coupled with our expertise in recovery-based psychotherapy, we are uniquely poised to develop an innovative treatment for Veterans struggling with PACS. Our intervention aims to improve psychological adjustment to PACS symptoms, promote resiliency, and facilitate coping, all of which can impact functional status and quality of life. The PACS-Coping and Recovery (PACS-CR) intervention we aim to develop focuses on psychological adjustment and coping, and augments medical, rehabilitative and neurological treatment for this population. Our approach is based on the CHIME model of personal recovery which includes five overarching processes: 1) Connectedness; 2) Hope and optimism about the future; 3) Identity; 4) Meaning in life; and 5) Empowerment. We will target the CHIME processes using established psychotherapeutic techniques such as skills training, acceptance-based and identity-based principles. Based on adaptations from existing recovery-based and COVID-19 distress group interventions that our team has developed and piloted, we are proposing a treatment framework that consists of a core of twelve 90-minutes sessions (1x/week x 12 weeks) with additional weekly sessions on specialized topics that are optional. We are proposing a treatment development NIH Stage 1A study to develop a Post-Acute COVID-19 Syndrome psychotherapeutic intervention, “PACS Coping and Recovery” (PACS-CR) through an iterative development process while collecting pilot data to assess its acceptability and feasibility. Our treatment development SPiRE will focus on 1) determining the treatment needs of Veterans with PACS, 2) developing the treatment using pilot qualitative data and aided by stakeholder feedback, 3) refining the intervention by three iterative pilots of our groups, testing both in person and telehealth versions. Pre and post measures will be utilized to track functional improvement and the degree to which this recovery-focused intervention has enabled the veterans to engage in meaningful life changes.

项目摘要 目前，美国有3,460万人，在资深事务中进行了测试或治疗的273,232名退伍军人 设施签约了Covid-19。虽然急性后共证综合征（PAC）的确切患病率 退伍军人是未知的，使用大量全球covid-19对精神病/神经系统PAC的估计 患者（n = 236,379）表明，大约11,390,400名美国人的患病率和90,311名退伍军人 VA护理，费率可能会随着时间而增加。此外，大规模研究表明多达35％的个体 经历功能障碍，在COVID-19之后8个月，感染后精神疾病的高患病率很高 包括焦虑症，抑郁症和创伤后应激障碍。使用我们的纵向数据 西奈山登记处（N≈1200）和当地詹姆斯·J·彼得斯（James J. Peters）的学术会员，伊坎医学院 VA的临床PACS计划，再加上我们在基于恢复心理治疗方面的专业知识，我们是独特的 被毒性为退伍军人与PACS斗争的创新待遇。 我们的干预旨在改善对PACS符号的心理调整，促进弹性并促进 应对，所有这些都会影响功能状况和生活质量。 PACS培训和恢复（PACS-CR） 干预措施我们旨在发展侧重于心理调整和应对，并增强医学， 该人群的康复和神经治疗。我们的方法基于 个人恢复包括五个总体过程：1）连接； 2）对 未来； 3）身份； 4）生活中的意义； 5）授权。我们将使用 建立的心理治疗技术，例如技能培训，基于认可和基于身份的技术 原则。 基于我们团队现有的基于恢复和共同的遇险小组干预措施的改编 已经开发和驾驶，我们提出了一个由十二个90分钟的核心组成的治疗框架 会议（1x/周x 12周），每周一次，额外关于可选的专业主题。我们是 提出一项治疗开发NIH 1A阶段研究，以发展急性后Covid-19综合征 心理治疗干预，“ PACS应对和恢复”（PACS-CR）通过迭代发展 在收集飞行员数据以评估其可接受性和可行性的同时进行处理。 我们的治疗开发尖峰将重点放在1）确定PAC的退伍军人的治疗需求，2） 使用飞行员定性数据开发治疗，并在利益相关者的反馈下帮助，3）完善 我们小组的三个迭代小球的干预，亲自测试和远程医疗版本。前后 措施将用于跟踪功能改进以及以这种恢复为中心的程度 干预使退伍军人能够从事有意义的生活变化。