Internet-based Self-Management Intervention for Prolonged Grief

基于互联网的长期悲伤自我管理干预

基本信息

批准号：
7540959
负责人：
BRETT T LITZ
金额：
$ 20.93万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-12-14 至 2010-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7540959
关键词：
Address Anxiety Behavior Bereavement Boston Cancer Center Cancer Patient Caring Cessation of life Chronic Clinical Clinical Trials Cognition Consensus Dana-Farber Cancer Institute Data Development Disease Early treatment Family member Feedback Goals Gray unit of radiation dose Grief reaction Health Homicide Hospice Programs Hospitals Individual Institute of Medicine (U.S.)Internet Intervention Laws Life Literature Malignant Neoplasms Measures Mediation Medical Mental Health Mental disorders Methods Monitor Morbidity - disease rate Neonatal Intensive Care Units Online Systems Palliative Care Participant Patients Population Post-Traumatic Stress Disorders Prevention program Preventive Intervention Productivity Protocols documentation Provider Psychiatry Public Health Quality-Adjusted Life Years Research Resources Risk Safety Secondary Prevention Self Care Self Efficacy Self Management Severities Solutions Stigmatization Suicide Survivors Symptoms Techniques Technology Testing Time Touch sensation Treatment Efficacy Treatment Protocols Universities Woman Work base caregiving clinical infrastructure clinically significant cognitive behavior therapy compliance behavior cost depression design evidence base functional disability hospice environment medical schools medical specialties meetings oncology pilot trial prevent programs psychosocial skills social tool trauma centers treatment response yearning

项目摘要

DESCRIPTION (provided by applicant): Prolonged Grief Disorder (PGD) is a psychiatric condition more severe and unremitting than normative grief, occurring in about 10% of bereavement. It is marked by prolonged yearning for the deceased, bitterness, interpersonal disengagement, and a sense of meaninglessness. PGD is associated with considerable functional impairment, physical and mental health morbidity, lost productivity, suicide, and lowered quality adjusted life years. At present, there are no evidence-based, secondary prevention interventions for PGD. The long-term goal of this research is to address the need for an efficacious, cost-effective, resource-efficient, and readily tolerated secondary prevention intervention for those at risk for developing PGD. The primary objective is to develop and pilot-test an internet-based self-management intervention for PGD that employs empirically derived cognitive-behavioral therapy (CBT) strategies to promote stable, active routines, self-care, accommodation of loss, enhanced self-efficacy, reengagement in pleasurable activities, and reattachment with significant others. The proposed work capitalizes on established CBT techniques and recent research on using the internet to deliver CBT interventions, and is intended to provide the necessary development and pilot work for a large clinical trial. The key hypothesis is that this intervention will reduce PGD symptoms and associated functional impairments. We hypothesize that participation in the intervention will be high due to the increased anonymity and accessibility afforded by the internet, which reduces stigmatization, increases treatment compliance, and, in turn, will increase treatment response. We will accomplish the objectives by pursuing these specific aims: (1) Search the loss and PGD literature and collaborate with experts to develop an experiential and skills-based, 6- week, therapist-assisted self-management protocol; (2) Develop a tool to assess the maladaptive cognitions and perceived barriers that may prevent PGD patients engaging in effective self-care, and reengaging their social circle (and implement the tool in the intervention); (3) Develop and refine an interactive, easy-to-negotiate internet interface with underlying data capture and treatment monitoring capabilities to implement the protocol; (4) Validate and standardize the treatment protocol and internet interface based on feedback from experts, care providers, and patients; (5) Conduct a pilot trial to determine feasibility, safety, efficacy of the intervention, the usefulness of the internet treatment delivery and monitoring technology, and further refine the intervention based on feedback from participants who complete the protocol.

描述（由申请人提供）：长期悲伤障碍 (PGD) 是一种比正常悲伤更严重、更持久的精神疾病，约 10% 的丧亲者会发生这种情况。它的特点是对死者的长期思念、痛苦、人际疏离和无意义感。 PGD 与相当大的功能障碍、身心健康发病率、生产力损失、自杀和质量调整生命年降低相关。目前，尚无基于证据的 PGD 二级预防干预措施。本研究的长期目标是满足有 PGD 风险的人群对有效、具有成本效益、资源高效且易于耐受的二级预防干预的需求。主要目标是开发并试点基于互联网的 PGD 自我管理干预措施，该干预措施采用经验派生的认知行为治疗 (CBT) 策略来促进稳定、积极的日常生活、自我护理、适应失落、增强自我意识。效率、重新参与愉快的活动以及与其他重要的人重新建立联系。拟议的工作利用了现有的 CBT 技术和最近使用互联网提供 CBT 干预的研究，旨在为大型临床试验提供必要的开发和试点工作。关键假设是这种干预将减少 PGD 症状和相关的功能障碍。我们假设，由于互联网提供的匿名性和可访问性增加，干预的参与度将会很高，这减少了污名化，提高了治疗依从性，进而提高了治疗反应。我们将通过追求以下具体目标来实现目标： (1) 搜索损失和 PGD 文献，并与专家合作制定基于经验和技能的、为期 6 周、治疗师协助的自我管理方案； (2) 开发一种工具来评估可能妨碍 PGD 患者进行有效自我护理和重新融入社交圈的适应不良认知和感知障碍（并在干预中实施该工具）； (3) 开发和完善一个交互式、易于协商的互联网接口，具有底层数据捕获和处理监控功能以实施该协议； (4) 根据专家、护理人员和患者的反馈验证和标准化治疗方案和互联网接口； (5) 进行试点试验，以确定干预措施的可行性、安全性、有效性、互联网治疗提供和监测技术的有用性，并根据完成方案的参与者的反馈进一步完善干预措施。