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: 10586328
• 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/10586328
• 关键词: Activities of Daily Living; Acute; Address; American; Anxiety; Anxiety Disorders; Arthralgia; COVID-19; COVID-19 patient; Cardiovascular system; Caring; Chronic; Climacteric; Clinical; Consultations; Contracts; Coping Skills; Coupled; Data; Development; Disease; Distress; Education; 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; base; cohort; common symptom; coping; coronavirus disease; design; disorder later incidence prevention; empowerment; experience; fitness; flexibility; follow-up; functional disability; functional improvement; functional status; group intervention; health assessment; improved; innovation; interdisciplinary approach; medical schools; neurological rehabilitation; novel; optimism; physical conditioning; post SARS-CoV-2 infection; programs; psychosocial; pulmonary symptom; rehabilitation strategy; resilience; satisfaction; skills; skills training; sleep health; symptomatology; telehealth; therapy development

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3460万人、273,232名退伍军人在退伍军人事务部接受了检测或治疗 设施感染了 COVID-19，而急性后 COVID-19 综合症 (PACS) 的确切患病率。 退伍军人未知，使用全球大量 COVID-19 样本对精神病学/神经学 PACS 进行估计 患者 (N=236,379) 表明，大约有 11,390,400 名美国人和 90,311 名退伍军人患病 此外，大规模研究表明，VA 护理率可能会随着时间的推移而增加，高达 35%。 COVID-19 后 8 个月出现功能障碍，感染后精神疾病患病率很高 使用我们的纵向数据，包括焦虑症、抑郁症和创伤后应激障碍。 学术附属机构、西奈山伊坎医学院的新冠病毒登记处 (n≈1200) 和当地 James J. Peters VA 的临床 PACS 计划，加上我们在基于康复的心理治疗方面的专业知识，使我们具有独特的优势 准备为患有 PACS 的退伍军人开发一种创新疗法。 我们的干预措施旨在改善对 PACS 症状的心理适应、增强弹性并促进 应对，所有这些都会影响功能状态和生活质量（PACS-CR）。 我们旨在开发的干预措施侧重于心理调整和应对，并增强医疗、 我们针对这一人群的康复和神经治疗方法基于 CHIME 模型。 个人康复包括五个总体过程：1）联系；2）希望和乐观； 未来；3) 身份；4) 生命的意义；以及 5) 我们将利用 CHIME 流程来实现目标。 已建立的心理治疗技术，例如技能培训、基于接受和基于身份的心理治疗技术 原则。 根据我们团队对现有基于恢复和 COVID-19 困扰群体干预措施的改编 已经开发并试点，我们提出了一个治疗框架，其中包括十二个 90 分钟的核心 课程（1 次/周 x 12 周）以及可选的每周额外课程。 提议进行治疗开发 NIH 1A 阶段研究以开发急性后 COVID-19 综合症 通过迭代开发的心理治疗干预“PACS 应对和恢复”(PACS-CR) 过程，同时收集试点数据以评估其可接受性和可行性。 我们的治疗开发 SPiRE 将重点关注 1) 通过 PACS 确定退伍军人的治疗需求，2) 使用试点定性数据并在利益相关者反馈的帮助下开发治疗方法，3）完善 我们小组的三名迭代试点进行干预，在现场和远程医疗版本之前和之后进行测试。 将利用措施来跟踪功能改进以及这种以恢复为重点的程度 干预使退伍军人能够进行有意义的生活改变。