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Effectiveness of a psychoeducation group intervention conducted by primary healthcare nurses in patients with depression and physical comorbidity: study protocol for a randomized, controlled trial.

ABSTRACT: BACKGROUND:Depressive disorders are the third leading cause of consultation in primary care, mainly in patients with chronic physical illnesses. Studies have shown the effectiveness of group psychoeducation in reducing symptoms in depressive individuals. Our primary aim is to evaluate the effectiveness of an intervention based on a psychoeducational program, carried out by primary care nurses, to improve the remission/response rate of depression in patients with chronic physical illness. Secondarily, to assess the cost-effectiveness of the intervention, its impact on improving control of the physical pathology and quality of life, and intervention feasibility. METHODS/DESIGN:A multicenter, randomized, clinical trial, with two groups and one-year follow-up evaluation. Economic evaluation study. SUBJECTS:We will assess 504 patients (252 in each group) aged >?50?years assigned to 25 primary healthcare centers (PHC) from Catalonia (urban, semi-urban, and rural). Participants suffer from major depression (Beck depression inventory: BDI-II 13-28) and at least one of the following: type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma, and/or ischemic cardiopathy. Patients with moderate/severe suicide risk or severe mental disorders are excluded. Participants will be distributed randomly into the intervention group (IG) and control (CG). INTERVENTION:The IG will participate in the psychoeducational intervention: 12 sessions of 90?min, once a week led by two Primary Care (PC) nurses. The sessions will consist of health education regarding chronic physical illness and depressive symptoms. MAIN MEASUREMENTS:Clinical remission of depression and/or response to intervention (BDI-II). SECONDARY MEASUREMENTS:Improvement in control of chronic diseases (blood test and physical parameters), drug compliance (Morinsky-Green test and number of containers returned), quality of life (EQ-5D), medical service utilization (appointments and hospital admissions due to complications), and feasibility of the intervention (satisfaction and compliance). Evaluations will be blinded, and conducted at baseline, post-intervention, and 12?months follow-up. DISCUSSION:Results could be informative for efforts to prevent depression in patients with a chronic physical illness. TRIAL REGISTRATION:NCT03243799 (registration date August 9, 2017).

SUBMITTER: Casanas R

PROVIDER: S-EPMC6595681 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Effectiveness of a psychoeducation group intervention conducted by primary healthcare nurses in patients with depression and physical comorbidity: study protocol for a randomized, controlled trial.

Casañas Rocío R Martín Royo Jaume J Fernandez-San-Martín Maria Isabel MI Raya Tena Antonia A Mendioroz Jacobo J Sauch Valmaña Glòria G Masa-Font Roser R Casajuana-Closas Marc M Fernandez Linares Eva María EM Cols-Sagarra Cèlia C Gonzalez Tejón Susana S Foguet-Boreu Quintí Q Martín Lopez Luis Miguel LM

BMC health services research 20190626 1

<h4>Background</h4>Depressive disorders are the third leading cause of consultation in primary care, mainly in patients with chronic physical illnesses. Studies have shown the effectiveness of group psychoeducation in reducing symptoms in depressive individuals. Our primary aim is to evaluate the effectiveness of an intervention based on a psychoeducational program, carried out by primary care nurses, to improve the remission/response rate of depression in patients with chronic physical illness. ...[more]

PMID: 31242892

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Project description:BackgroundEmergency responders are routinely exposed to traumatic critical incidents and other occupational stressors that place them at higher risk of mental ill health compared to the general population. There is some evidence to suggest that resilience training may improve emergency responders' wellbeing and related health outcomes. The aim of this study was to evaluate the effectiveness of a tertiary service resilience intervention compared to psychoeducation for improving psychological outcomes among emergency workers.MethodsWe conducted a multicentre, parallel-group, randomised controlled trial. Minim software was used to randomly allocate police, ambulance, fire, and search and rescue services personnel, who were not suffering from depression or post-traumatic stress disorder, to Mind's group intervention or to online psychoeducation on a 3:1 basis. The resilience intervention was group-based and included stress management and mindfulness tools for reducing stress. It was delivered by trained staff at nine centres across England in six sessions, one per week for six weeks. The comparison intervention was psychoeducation about stress and mental health delivered online, one module per week for six weeks. Primary outcomes were assessed by self-report and included wellbeing, resilience, self-efficacy, problem-solving, social capital, confidence in managing mental health, and number of days off work due to illness. Follow-up was conducted at three months. Blinding of participants, researchers and outcome assessment was not possible due to the type of interventions.ResultsA total of 430 participants (resilience intervention N = 317; psychoeducation N = 113) were randomised and included in intent-to-treat analyses. Linear Mixed-Effects Models did not show a significant difference between the interventions, at either the post-intervention or follow-up time points, on any outcome measure.ConclusionsThe limited success of this intervention is consistent with the wider literature. Future refinements to the intervention may benefit from targeting predictors of resilience and mental ill health.Trial registrationISRCTN registry, ISRCTN79407277.

Project description:BackgroundPostpartum depression (PPD) is one of the leading causes of maternal morbidity, affecting up to 18% of Canadian new mothers. Yet, PPD often remains untreated due to numerous barriers in access to care, including location and cost. Development of eHealth interventions in collaboration with patient partners offers an exciting opportunity to fill this care gap and provide effective and affordable care to new parents across British Columbia.ObjectiveOur aim was to determine the content and design preferences of women previously diagnosed with PPD to inform changes to the development of a web-enabled intervention for education and management of PPD.MethodsWebpage prototypes were created to mimic the web-enabled resource using findings from completed focus group research that assessed what women want in a web-enabled support resource for PPD. A convenience sample of women aged >18 years and previously diagnosed with PPD was recruited. Feedback was collected on the content and design of the prototypes via semistructured interviews and online surveys. Qualitative, inductive analytic, and quantitative methods were used.ResultsA total of 9 women (mean age 37.2 years, SD 4.8 years) completed the interview and a majority of the survey. The following 6 themes were identified: (1) inefficacy of text-heavy layouts, (2) highlighting key information, (3) clarity/understandability of the language, (4) finding support groups, (5) validation and immediate help for feelings of isolation, and (6) helpfulness and accessibility of the resource. Each theme identified elements of content or design that were either effective or may be improved upon. Most women (8/9, 89%) favored content relating to foundational knowledge of PPD, such as symptoms and management options. The layout, language, and content were found to be generally easy to understand, clear, trustworthy, and helpful.ConclusionsSix key areas were identified by women previously diagnosed with PPD, as requiring focus in a web-enabled psychoeducation program. Consistent with past research, this study also found that support and enthusiasm for web-enabled programs support PPD management as an adjunct to other evidence-based treatments.

Project description:The World Health Organization leads a global strategy to promote the initiation and maintenance of breast-feeding. Existing literature shows that education and supportive interventions, both for breast-feeding mothers as well as for healthcare professionals, can increase the proportion of women that use exclusive breast-feeding, however, more evidence is needed on the effectiveness of group interventions.This study involves a community-based cluster randomised trial conducted at Primary Healthcare Centres in the Community of Madrid (Spain). The project aims to evaluate the effectiveness of an educational group intervention performed by primary healthcare professionals in increasing the proportion of mother-infant pairs using exclusive breastfeeding at six months compared to routine practice. The number of patients required will be 432 (216 in each arm). All mother-infant pairs using exclusive breastfeeding that seek care or information at healthcare centres will be included, as long as the infant is not older than four weeks, and the mother has used exclusive breastfeeding in the last 24 h and who gives consent to participate. The main response variable is mother-infant pairs using exclusive breast-feeding at six months. Main effectiveness will be analysed by comparing the proportion of mother-infant pairs using exclusive breast-feeding at six months between the intervention group and the control group. All statistical tests will be performed with intention-to-treat. The estimation will be adjusted using an explanatory logistic regression model. A survival analysis will be used to compare the two groups using the log-rank test to assess the effect of the intervention on the duration of breastfeeding. The control of potential confounding variables will be performed through the construction of Cox regression models.We must implement strategies with scientific evidence to improve the percentage of exclusive breast-feeding at six months in our environment as established by the WHO. Group education is an instrument used by professionals in Primary Care that favours the acquisition of skills and modification of already-acquired behaviour, all making it a potential method of choice to improve rates of exclusive breast-feeding in this period.The trial was registered with ClinicalTrials.gov under code number NCT01869920 (Date of registration: June 3, 2013).

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Effectiveness of a psychoeducation group intervention conducted by primary healthcare nurses in patients with depression and physical comorbidity: study protocol for a randomized, controlled trial.

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Effectiveness of a psychoeducation group intervention conducted by primary healthcare nurses in patients with depression and physical comorbidity: study protocol for a randomized, controlled trial.

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