Coping and learning to Manage Stress with cystic fibrosis (CALM): A multisite telehealth randomized controlled trial to reduce depression and anxiety symptoms in adults with cystic fibrosis.

IF 5.4 2区 医学 Q1 RESPIRATORY SYSTEM Journal of Cystic Fibrosis Pub Date : 2024-11-24 DOI:10.1016/j.jcf.2024.11.002
Christina J Bathgate, Elizabeth D Smith, Nora H Murphy, Alexandra L Quittner, Kristin A Riekert, Jennifer L Goralski, Kristen E Holm
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Abstract

Background: Adults with cystic fibrosis (AWCF) have higher rates of depression and anxiety than comparable community members. This multisite randomized waitlist-controlled trial tested the efficacy of "Coping and Learning to Manage Stress with CF" (CALM), a 6-session+booster telehealth intervention to improve depression and anxiety symptoms (primary outcomes) and perceived stress, coping self-efficacy, and key health-related quality of life domains (secondary outcomes).

Methods: AWCF reporting mild to severe symptoms of depression and/or anxiety were randomized to receive CALM immediately (immediate, n = 66) or after a 13-week delay (waitlist, n = 66). Group differences post-intervention and at 1-month were examined via linear mixed models. Maintenance of treatment gains from baseline to 3-month follow-up was examined using combined data from both groups. Effect size calculations using Cohen's d assessed treatment effect magnitude.

Results: Compared to the waitlist group, those that received CALM immediately reported lower depression and anxiety symptoms post-intervention and at 1-month follow-up (ps<0.001). For depression there was a large effect size post-intervention (d = 0.85) and a medium effect size at 1-month follow-up (d = 0.70); anxiety had a medium effect size post-intervention (d = 0.65) and at 1-month follow-up (d = 0.66). The immediate group also reported significantly higher coping self-efficacy, less stress, and increased vitality post-CALM and at 1-month follow-up (ps<0.01). Treatment gains were maintained at 3-month follow-up for all outcomes.

Conclusions: CALM was efficacious for AWCF in reducing symptoms of depression, anxiety, and perceived stress while improving coping self-efficacy and vitality with evidence of treatment sustainability. Next steps are dissemination and implementation to CF psychosocial clinicians.

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应对和学会管理囊性纤维化压力(CALM):一项多站点远程保健随机对照试验,旨在减轻囊性纤维化成人患者的抑郁和焦虑症状。
背景:患有囊性纤维化的成年人(AWCF)的抑郁和焦虑率高于同类社区成员。这项多站点随机候选名单对照试验测试了 "应对并学会管理囊性纤维化压力"(CALM)的疗效,这是一项为期 6 个疗程+增强型远程保健干预措施,旨在改善抑郁和焦虑症状(主要结果)以及感知压力、应对自我效能和主要健康相关生活质量领域(次要结果):方法:报告轻度至重度抑郁和/或焦虑症状的 AWCF 被随机分配到立即接受 CALM(立即,66 人)或延迟 13 周后接受 CALM(等待,66 人)。干预后和1个月时的组间差异通过线性混合模型进行检验。使用两组的综合数据,考察了从基线到 3 个月随访期间治疗效果的维持情况。疗效大小计算采用 Cohen's d 评估治疗效果的大小:结果:与候补名单组相比,立即接受 CALM 治疗的患者在干预后和随访 1 个月时的抑郁症状和焦虑症状均有所减轻(结论:CALM 治疗对抑郁症和焦虑症患者具有疗效:CALM对AWCF有一定疗效,可以减轻抑郁症状、焦虑和压力感,同时提高自我应对能力和活力,有证据表明治疗具有可持续性。下一步工作是向CF心理临床医生推广和实施。
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来源期刊
Journal of Cystic Fibrosis
Journal of Cystic Fibrosis 医学-呼吸系统
CiteScore
10.10
自引率
13.50%
发文量
1361
审稿时长
50 days
期刊介绍: The Journal of Cystic Fibrosis is the official journal of the European Cystic Fibrosis Society. The journal is devoted to promoting the research and treatment of cystic fibrosis. To this end the journal publishes original scientific articles, editorials, case reports, short communications and other information relevant to cystic fibrosis. The journal also publishes news and articles concerning the activities and policies of the ECFS as well as those of other societies related the ECFS.
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