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Odzakovic E, Allgurin M, Jonasson LL, Öberg S, Fridlund B, Ulander M, Lind J, Broström A. Experiences of facilitators and barriers for fulfilment of human needs when living with restless legs syndrome: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2348884. [PMID: 38735061 PMCID: PMC11089917 DOI: 10.1080/17482631.2024.2348884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/25/2024] [Indexed: 05/14/2024] Open
Abstract
PURPOSE Restless Legs Syndrome (RLS) is a widespread condition that affects sleep leading to daytime sleepiness, depression, and reduced quality of life. This study aims to determine and describe how patients with RLS experience their everyday life, with a focus on facilitators and barriers related to Maslow's hierarchical theory of human needs. METHOD Semi-structured interviews were analysed with qualitative content analysis resulting in facilitators and barriers affecting the fulfilment of the five human needs. RESULTS Addressing RLS symptoms through medications and a quiet sleep environment fulfils psychological needs. Control over RLS symptoms, engagement in activities, trust in treatments, and social support meet safety and security needs. Social inclusion, close relationships, and meaningful interactions fulfil a sense of belongingness and love needs despite RLS. Competence in managing RLS, effective self-care strategies, confident communication, and trust-building support esteem needs. Finally, comprehensive understanding through person-centred interventions and coping fulfils the self-actualization needs in managing RLS. CONCLUSION Holistic and person-centred interventions, including facilitators for the fulfilment of physiological, psychological, and social needs could help healthcare professionals to provide holistic care.
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Affiliation(s)
- Elzana Odzakovic
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Monika Allgurin
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Sandra Öberg
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bengt Fridlund
- Centre for Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
| | - Martin Ulander
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
| | - Jonas Lind
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
- Section of Neurology, Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Anders Broström
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Miqdadi AI, Chong MC, Tang LY, Koh OH, Alhadidi M, Issa M. Easing Panic: The Effect of an Online Psychoeducational Program on Panic Symptoms, Anxiety, and Quality of Life Among People Experiencing Panic Attacks. Issues Ment Health Nurs 2024:1-12. [PMID: 39303164 DOI: 10.1080/01612840.2024.2384412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2024]
Abstract
Panic attacks (PAs) are intense episodes of anxiety with severe physical symptoms that can impair an individual's social and occupational functions. Psychoeducation, a structured educational intervention, aims to improve various health aspects, including mental disorders. Delivering psychoeducation via the Internet can overcome barriers to accessing mental health treatment. This study examined the effectiveness of online psychoeducation on panic symptoms, anxiety, and quality of life (QOL) among people experiencing PAs. In this quasi-experimental design, 157 participants with PAs were recruited, and 136 eligible participants were allocated to treatment and control groups. The treatment group received an eight-session online psychoeducational program over 8 weeks, while the control group received reading materials. Outcome variables, including panic symptoms, anxiety, and QOL, were measured at baseline, 1-week post-intervention, and at 8-week follow-up using the Panic Disorder Dimensional (PD-D) scale, the Generalized Anxiety Disorder (GAD-7) scale, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF), respectively. In the treatment group, the split-plot ANOVA showed a significant reduction in panic symptoms [F(1, 98) = 18.86, p < 0.01] and anxiety [F(1, 98) = 18.241, p < 0.01] compared to the control group. However, the intervention did not significantly affect QOL [F(1, 98) = 0.278, MSE = 153.007, p > 0.05]. The online psychoeducational program effectively reduced panic symptoms and anxiety levels but did not significantly impact QOL. Internet-based interventions, including psychoeducation, can improve access to mental health treatment, potentially reducing the treatment gap and enhancing overall mental health outcomes.
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Affiliation(s)
- Ahmad I Miqdadi
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei-Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Li-Yoong Tang
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ong-Hui Koh
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Majdi Alhadidi
- Faculty of Nursing, Al- Zaytoonah University of Jordan (ZUJ), Amman, Jordan
| | - Mohammed Issa
- Psychiatrist, Psychosexual and Relationship Therapist, Quareb Mental Health Clinic, Cairo, Egypt
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Carona C, Pereira M, Araújo-Pedrosa A, Monteiro F, Cristina Canavarro M, Fonseca A. For Whom and for How Long Does the "Be a Mom" Intervention Work? A Secondary Analysis of Data From a Randomized Controlled Trial Exploring the Mid-Term Efficacy and Moderators of Treatment Response. Behav Ther 2024; 55:768-785. [PMID: 38937049 DOI: 10.1016/j.beth.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 09/20/2023] [Accepted: 11/07/2023] [Indexed: 06/29/2024]
Abstract
This study explored clinical and sociodemographic moderators of treatment response to "Be a Mom", an internet-based cognitive behavioral therapy (iCBT) intervention, from baseline to postintervention, in women at high risk for postpartum depression (PPD). The study also assessed the stability of women's treatment gains from baseline to 4-months postintervention (follow-up). This open-label randomized controlled trial (RCT) involved a sample of 1,053 postpartum Portuguese women identified as being at high risk for PPD (i.e., having a score of 5.5 or higher on the Postpartum Depression Predictors Inventory-Revised); participants were allocated to "Be a Mom" intervention group or a waiting-list control group, and completed self-report measures at baseline, postintervention, and a 4-month follow-up (554 women completed follow-up assessments). Depressive and anxiety symptoms were measured using the Edinburgh Postnatal Depression Scale and the anxiety subscale of the Hospital Anxiety and Depression Scale, and flourishing/positive mental health was assessed with the Mental Health Continuum. Regression models and linear mixed models were used to examine moderators of treatment and the mid-term efficacy of the "Be a Mom" intervention, respectively. The results revealed that treatment completion, higher depression scores at baseline, and higher income levels were linked to greater symptom reduction and positive mental health enhancement. Moreover, the efficacy of the "Be a Mom" intervention was supported at the 4-month follow-up. The "Be a Mom" intervention appears to be an effective iCBT tool for reducing psychological distress and enhancing positive mental health in women at risk for PPD, with therapeutic improvements maintained over a 4-month period.
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Donkin L, Bidois-Putt MC, Wilson H, Hayward P, Chan AHY. An Exploration of the Goodness of Fit of Web-Based Tools for Māori: Qualitative Study Using Interviews and Focus Groups. JMIR Form Res 2024; 8:e50385. [PMID: 38696236 PMCID: PMC11099811 DOI: 10.2196/50385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/12/2023] [Accepted: 11/22/2023] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Indigenous communities often have poorer health outcomes and services under traditional models of care. In New Zealand, this holds true for Māori people who are tāngata whenua (the indigenous people). Several barriers exist that decrease the likelihood of indigenous communities often have poorer health outcomes and poor service fit under traditional models of care, including access issues, systemic and provider racism, and a lack of culturally safe and responsive services. Web-based interventions (WBIs) have been shown to be effective in supporting mental health and well-being and can overcome some of these barriers. Despite the large number of WBIs developed, more investigation is needed to know how well WBIs fit with an indigenous worldview and how they meet the needs of indigenous communities so that a digitally based future does not drive social and health inequities. OBJECTIVE This study aims to explore the goodness-of-fit of WBIs of Māori individuals, the indigenous people of Aotearoa/New Zealand. METHODS We used interviews (n=3) and focus groups (n=5) with 30 Māori participants to explore their views about WBIs. Interviews were analyzed using reflexive thematic analysis by members of the research team. RESULTS Overall, there was a perception that the design of WBIs did not align with the Māori worldview, which centers around people, relationships, spirituality, and holistic views of well-being. A total of 4 key themes and several subthemes emerged, indicating that WBIs were generally considered a poor fit for Māori. Specifically, the themes were as follows: (1) WBIs are disconnected from the core values of te ao Māori (the Māori worldview), (2) WBIs could be helpful in the right context, (3) there are significant barriers that may make it harder for Māori to use WBIs than other groups, and (4) ways to improve WBIs to help engagement with Māori. CONCLUSIONS While WBIs are often considered a way to reduce barriers to care, they may not meet the needs of Māori when used as a stand-alone intervention. If WBIs are continued to be offered, developers and researchers need to consider how to develop WBIs that are responsive and engaging to the needs of indigenous communities rather than driving inequities. Ideally, WBIs should be developed by the people they are intended for to fit with those populations' world views.
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Affiliation(s)
- Liesje Donkin
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | | | - Holly Wilson
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Penelope Hayward
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - Amy Hai Yan Chan
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
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Kong F, Yu L, Hou Y, Zhu L, Zhou J, Huang L, Lv Y, Wang L, Zhang L, Yang Y, Ying Y. Efficacy of Internet-Based Cognitive Behavioral Therapy for Subthreshold Depression Among Older Adults in Institutional Long-Term Care Settings: Pragmatic Randomized Controlled Trial. J Med Internet Res 2024; 26:e40187. [PMID: 38427424 PMCID: PMC10943436 DOI: 10.2196/40187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Subthreshold depression (sD) is prevalent in older populations in long-term care (LTC) settings, but psychological therapy in LTC settings in China is not readily available. Thus, internet-based cognitive behavioral therapy (ICBT) may be suitable for this population, but research on the efficacy of ICBT for older adults with sD, especially those living in LTC settings, is limited. OBJECTIVE This study aimed to evaluate the efficacy and acceptability of ICBT treatment for sD among LTC residents in China. We also examined whether ICBT is as effective as group-based cognitive behavioral therapy (CBT) for treating sD in this population. METHODS We conducted a pragmatic randomized controlled trial, which included 18 LTC institutions. A total of 354 participants were randomized to ICBT, group-based CBT, or a waiting list and were followed up for 12 months. The primary outcome was self-reported depressive symptoms on the Center for Epidemiological Studies Depression Scale (CES-D). Secondary outcomes were the scores of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-Item (GAD-7), and Geriatric Depression Scale (GDS). A mixed-effects model was used to assess the efficacy of ICBT. RESULTS The ICBT group showed a significant improvement in self-reported depressive symptoms, which was maintained at the 12-month follow-up (all P<.001). The ICBT group exhibited a significantly larger reduction in the scores of the CES-D (Cohen d=0.07, 95% CI 0.04-0.09; P=.01), PHQ-9 (d=0.30, 95% CI 0.28-0.33; P<.001), GDS (d=0.10, 95% CI 0.08-0.13; P<.001), and GAD-7 (d=0.19, 95% CI 0.17-0.22; P<.001) compared with a waiting list at postintervention. ICBT had significantly stronger effects than CBT on the PHQ-9 and GAD-7 at postintervention (d=0.15, 95% CI 0.13-0.17; P<.001 and d=0.21, 95% CI 0.19-0.23; P<.001, respectively), 6-month follow-up (d=0.18, 95% CI 0.16-0.21; P<.001 and d=0.18, 95% CI 0.15-0.21; P<.001, respectively), and 12-month follow-up (d=0.15, 95% CI 0.11-0.19; P<.001 and d=0.18, 95% CI 0.14-0.21; P<.001, respectively). CONCLUSIONS ICBT is a relatively effective and acceptable intervention for reducing depressive symptoms among Chinese LTC residents with sD. These findings indicate the usefulness of ICBT application for sD in LTC settings. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000030697; https://www.chictr.org.cn/showproj.aspx?proj=50781.
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Affiliation(s)
- Fanqian Kong
- Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Libo Yu
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | | | - Lijie Zhu
- Pfizer Research and Development Co, Ltd, Shanghai, China
| | - Jing Zhou
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Lingjie Huang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yueer Lv
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Wang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Li Zhang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yiling Yang
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Yuchen Ying
- Ningbo College of Health Sciences, Ningbo, Zhejiang, China
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Kahlon S, Gjestad R, Lindner P, Nordgreen T. Perfectionism as a predictor of change in digital self-guided interventions for public speaking anxiety in adolescents: A secondary analysis of a four-armed randomized controlled trial. Cogn Behav Ther 2024; 53:152-170. [PMID: 37991001 DOI: 10.1080/16506073.2023.2281243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
Public Speaking Anxiety (PSA) interventions targeting adolescents exist; however, not all gain improvement. This exploratory study investigated whether PSA interventions resulted in a decrease in perfectionism and whether pre-treatment level and changes in perfectionism moderated the effects on PSA and social anxiety. The sample consisted of 100 adolescents from junior high schools randomized to four groups: 1) VR only (n = 20), 2) VR + online exposure program (n = 20), 3) online psychoeducation and online exposure program (n = 40), 4) waitlist and online psychoeducation program (n = 20). Self-reported symptoms of PSA, social anxiety, and perfectionism were measured at pre, week 3, post, and 3-months follow-up. Level and change in outcome variables were analyzed using latent growth curve modeling. Results revealed that the interventions did not lead to a reduction in perfectionism. Reduction in perfectionism was associated with a larger reduction in all outcome measures from post to follow-up. No interaction was found between pre-treatment perfectionism and PSA symptoms. High pre-treatment levels of perfectionism were associated with poorer outcomes on social anxiety symptoms from post to follow-up for online exposure groups. The results indicate that one should assess and address high pre-treatment levels of perfectionism during PSA interventions.
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Affiliation(s)
- Smiti Kahlon
- Research Centre for Digital Mental Health Services, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Rolf Gjestad
- Research Department, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Tine Nordgreen
- Research Centre for Digital Mental Health Services, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Mide M, Mattiasson J, Norlin D, Sehlin H, Rasmusson J, Ljung S, Lindskog A, Petersson J, Saavedra F, Gordh AS. Internet-delivered therapist-assisted cognitive behavioral therapy for gambling disorder: a randomized controlled trial. Front Psychiatry 2023; 14:1243826. [PMID: 38146277 PMCID: PMC10749366 DOI: 10.3389/fpsyt.2023.1243826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
Objectives Cognitive behavioral therapy (CBT) is the most promising treatment for gambling disorder (GD) but only 21% of those with problematic gambling seek treatment. CBT over the Internet might be one way to reach a larger population. The aim of this study was to assess the effectiveness of Internet-delivered CBT with therapist guidance compared to an active control treatment. Methods Using a single-blinded design, 71 treatment-seeking gamblers (18-75 years) diagnosed with GD were randomized to 8 weeks of Internet-delivered CBT guided by telephone support, or 8 weeks of Internet-delivered motivational enhancement paired with motivational interviewing via telephone (IMI). The primary outcome was gambling symptoms measured at a first face-to-face assessment, baseline (treatment start), every 2 weeks, post-treatment, and 6-month follow-up. Gambling expenditures, time spent gambling, depression, anxiety, cognitive distortions, and quality of life were assessed as secondary outcomes. Analysis was performed on the full analysis sample (n = 60), with intention-to-treat sensitivity analyses (n = 69). Results In the CBT group, 80% stayed in treatment until the final week, compared to 67% in IMI. Post-treatment and at 6-month follow-up, no differences were found between CBT and IMI for any outcome measure. An exploratory analysis of the total sample (n = 60) showed a significant effect of time during treatment on gambling symptoms (d, [95% CI] 0.52, [-1.15, 2.02]) and all secondary outcomes except the gambling diary (depression (0.89, [-1.07-2.65]); anxiety (0.69, [-1.20-2.38])); cognitive distortions (0.84, [-0.73-2.29]); quality of life (0.60, [-0.61-1.70])). Post-treatment, there were no clinical gambling symptoms in either group. Some deterioration was seen between post-treatment and 6-month follow-up on gambling symptoms (0.42, [-1.74-2.43]), depression (0.59, [-0.82-1.86]), and anxiety (0.30, [-0.99-1.48]). Additionally, it was observed that the largest reduction in gambling symptoms was between the first assessment and baseline. Conclusion Both treatments offered in this study were effective at reducing gambling symptoms. It is also possible that the process of change started before treatment, which gives promise to low-intensity interventions for GD. Additional research is needed as this approach could be both cost-effective and has the potential to reach more patients in need of treatment than is currently possible. Clinical trial registration https://www.isrctn.com/, identifier ISRCTN38692394.
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Affiliation(s)
- Mikael Mide
- Department of Addiction Medicine, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jessica Mattiasson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - David Norlin
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Sehlin
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Josefine Rasmusson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sofia Ljung
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Amanda Lindskog
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonna Petersson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fanny Saavedra
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Söderpalm Gordh
- Department of Addiction Medicine, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
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Amiri F, Shiani A, Mirzaei M. To Be or Not to Be: Addressing of PRISMA Checklist for Reporting Systematic Reviews and Meta-Analyses. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:2228-2229. [PMID: 37899930 PMCID: PMC10612543 DOI: 10.18502/ijph.v52i10.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/28/2022] [Indexed: 10/31/2023]
Abstract
The Article Abstract is not available.
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Affiliation(s)
- Fatemeh Amiri
- Department of Radiology and Nuclear Medicine, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Shiani
- Department of Speech Therapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Mirzaei
- Department of Physiotherapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Wang AY, Vereschagin M, Richardson CG, Xie H, Hudec KL, Munthali RJ, Munro L, Leung C, Kessler RC, Vigo DV. Evaluating the Effectiveness of a Codeveloped e-Mental Health Intervention for University Students: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49364. [PMID: 37647105 PMCID: PMC10500355 DOI: 10.2196/49364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND University life typically occurs during a period of life transition, where the incidence of mental health and substance use problems and disorders peaks. However, relatively few students obtain effective treatment and support. e-Interventions have proven effective in improving the psychological outcomes of university students and have the potential to provide scalable services that can easily integrate into existing models of care. Minder is a mobile app codeveloped with university students that offers users a collection of evidence-based interventions tailored to help university students maintain their mental health and well-being and manage their substance use. OBJECTIVE This paper describes the protocol for a randomized controlled trial (RCT) that aims to assess the effectiveness of the Minder app in improving the mental health and substance use outcomes of university students. METHODS This study is a 2-arm, parallel assignment, single-blinded, 30-day RCT with 1 intervention group and 1 waitlist control group. Overall, 1496 (748 per trial arm) university students from the University of British Columbia Vancouver Campus (N=54,000) who are aged ≥17 years, have a smartphone with Wi-Fi or cellular data, and speak English will be recruited via a variety of web-based and offline strategies. Participants will be randomized into the intervention or control group after completing a baseline survey. Those randomized into the intervention group will gain immediate access to the Minder app and will be assessed at 2 weeks and 30 days. Those randomized into the control group will be given access to the app content after their follow-up assessment at 30 days. The primary outcomes are measured from baseline to follow-up at 30 days and include changes in general anxiety symptomology, depressive symptomology, and alcohol consumption risk measured by the General Anxiety Disorder 7-Item scale, Patient Health Questionnaire 9-Item scale, and US Alcohol Use Disorders Identification Test-Consumption Scale, respectively. Secondary outcomes include measures related to changes in the frequency of substance use, mental well-being, self-efficacy in managing mental health and substance use, readiness to change, and self-reported use of mental health services and supports (including referral) from baseline to follow-up at 30 days. RESULTS Trial recruitment and data collection began in September 2022, and the completion of data collection for the trial is anticipated by June 2023. As of May 10, 2023, a total of 1425 participants have been enrolled. CONCLUSIONS The RCT described in this protocol paper will assess whether the Minder app is effective in improving the mental health and substance use outcomes of a general population of Canadian university students. Additional secondary outcome research aims to explore additional outcomes of interest for further research and better understand how to support students' general mental well-being. TRIAL REGISTRATION ClinicalTrials.gov NCT05606601; https://clinicaltrials.gov/ct2/show/NCT05606601. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49364.
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Affiliation(s)
- Angel Y Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Melissa Vereschagin
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris G Richardson
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Kristen L Hudec
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lonna Munro
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Calista Leung
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Daniel V Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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10
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Kasteler R, Fuchs P, Otth M, Scheinemann K. Interventions to improve neurocognitive late-effects in pediatric and adolescent CNS tumor patients and survivors - a systematic review. Front Oncol 2023; 13:1150166. [PMID: 37205187 PMCID: PMC10185878 DOI: 10.3389/fonc.2023.1150166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Survival of children and adolescents diagnosed with central nervous system (CNS) tumors massively improved over the last decades due to better diagnostics, treatment, and supportive care. However, morbidity is still the highest of all cancer entities in this age group with neurocognitive late-effects being one of the most severe. Aim With this systematic review, we aim to summarize interventions designed to prevent or improve neurocognitive late-effects in CNS tumor patients. Method We searched PubMed on August 16th 2022 and included publications studying interventions for neurocognitive late-effects in pediatric and adolescent patients and survivors diagnosed with a CNS tumor. We included any form of neurocognitive intervention during treatment or following treatment completion. We considered all types of studies except for expert opinions and case reports. Results The literature search resulted in 735 publications. We included 43 publications in the full text screening and 14 met our inclusion criteria. Of those, two assessed the impact of pharmacological interventions, three of exercise interventions, five of online cognitive training, and four assessed behavioral interventions. Different neuropsychological test batteries and imaging were used to measure the impact of the respective interventions. Most studies showed a positive impact of the interventions in single to several of the subtests used. Conclusion We found several intervention studies indicating improvement of neurocognitive problems in children and adolescent CNS tumor survivors. In this population exercise interventions or online cognitive training might mitigate or improve neurocognitive late-effects.
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Affiliation(s)
- Rahel Kasteler
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland
- *Correspondence: Rahel Kasteler,
| | - Philipp Fuchs
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Kantonsspital Aarau, Aarau, Switzerland
| | - Maria Otth
- Department of Oncology, Hematology, Immunology, Stem Cell Transplantation and Somatic Gene Therapy, University Children’s Hospital Zurich, Zurich, Switzerland
- Division of Pediatric Hematology/Oncology, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Katrin Scheinemann
- Division of Pediatric Hematology/Oncology, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Division of Pediatric Hematology/Oncology, McMaster Children’s Hospital and McMaster University, Hamilton, ON, Canada
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Bisby MA, Titov N, Dear BF, Karin E, Wilhelms A, Nugent M, Hadjistavropoulos HD. Examining Change in the Frequency of Adaptive Actions as a Mediator of Treatment Outcomes in Internet-Delivered Therapy for Depression and Anxiety. J Clin Med 2022; 11:6001. [PMID: 36294322 PMCID: PMC9605214 DOI: 10.3390/jcm11206001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Adaptive actions, including healthy thinking and meaningful activities, have been associated with emotional wellbeing. The Things You Do Questionnaire-21 item (TYDQ-21) has recently been created to measure the frequency of such actions. A study using the TYDQ-21 found that adaptive actions increased across Internet-delivered therapy for symptoms of depression and anxiety, and higher TYDQ-21 scores were associated with lower psychological distress at post-treatment. The current study examined the relationships between adaptive actions and psychological distress among adults (n = 1114) receiving Internet-delivered therapy as part of routine care in Canada, and explored whether adaptive actions mediated reductions in depression and anxiety. As hypothesised, adaptive actions increased alongside reductions in depression and anxiety symptoms from baseline to post-treatment. Treatment effects were consistent when the intervention was provided with regular weekly therapist support or with optional weekly therapist support, and some (but not all) types of adaptive actions had a mediating effect on change in depressive symptoms. The present findings support further work examining adaptive actions as a mechanism of change in psychotherapy, as well as the utility and scalability of Internet-delivered treatments to target and increase adaptive actions with the aim of improving mental health.
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Affiliation(s)
- Madelyne A. Bisby
- eCentreClinic, School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney 2109, Australia
- MindSpot Clinic, MQ Health, Macquarie University, Sydney 2109, Australia
| | - Nickolai Titov
- MindSpot Clinic, MQ Health, Macquarie University, Sydney 2109, Australia
| | - Blake F. Dear
- eCentreClinic, School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney 2109, Australia
| | - Eyal Karin
- eCentreClinic, School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney 2109, Australia
| | - Andrew Wilhelms
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Marcie Nugent
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
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