{"id":26124,"date":"2024-07-27T04:54:00","date_gmt":"2024-07-26T20:54:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26124"},"modified":"2024-07-27T18:12:09","modified_gmt":"2024-07-27T10:12:09","slug":"jama-intern-med%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9aicu%e5%ad%98%e6%b4%bb%e6%82%a3%e8%80%85%e5%bf%83%e7%90%86%e5%ba%94%e6%bf%80%e7%9a%84%e7%a7%bb%e5%8a%a8%e6%ad%a3%e5%bf%b5%e5%b9%b2%e9%a2%84","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26124","title":{"rendered":"[JAMA Intern Med\u53d1\u8868\u8bba\u6587]\uff1aICU\u5b58\u6d3b\u60a3\u8005\u5fc3\u7406\u5e94\u6fc0\u7684\u79fb\u52a8\u6b63\u5ff5\u5e72\u9884"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

May 28, 2024<\/p>\n\n\n\n

Mobile Mindfulness Intervention for Psychological Distress Among Intensive Care Unit Survivors: A Randomized Clinical Trial<\/h1>\n\n\n\n

Christopher E. Cox, John A. Gallis, Maren K. Olsen, et al<\/h3>\n\n\n\n

JAMA Intern Med. <\/em>Published online May 28, 2024. doi:10.1001\/jamainternmed.2024.0823<\/a><\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the optimal method for delivering a mobile app\u2013based mindfulness program for intensive care unit survivors?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized clinical trial with 247 participants, the effect of 3 components (introduction to the program via the app vs a therapist call, twice-a-day vs once-a-day mindfulness meditation, and management of increasing depression symptoms during the intervention period by the app vs by therapist call) on depression symptoms were compared. Meditation twice a day was more effective than once a day; effects did not differ for the other 2 parameters.<\/p>\n\n\n\n

Meaning<\/strong>  In this study, an optimized version of the mindfulness intervention was fully mobile app\u2013based and scalable to address psychological distress symptoms among intensive care unit survivors.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Although psychological distress is common among survivors of critical illness, there are few tailored therapies.<\/p>\n\n\n\n

Objective<\/strong>  To determine the optimal method for delivering a mindfulness intervention via a mobile app for critical illness survivors.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This randomized clinical trial used a 2\u2009\u00d7\u20092\u2009\u00d7\u20092 factorial design and was conducted at 3 sites among survivors of critical illness with elevated postdischarge symptoms of depression. The study was conducted between August 2019 and July 2023.<\/p>\n\n\n\n

Interventions<\/strong>  Participants were randomized to 1 of 8 different groups as determined by 3 two-level intervention component combinations: intervention introduction method (mobile app vs therapist call), mindfulness meditation dose (once daily vs twice daily), and management of increasing symptoms (mobile app vs therapist call).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was the 9-item Patient Health Questionnaire (PHQ-9) depression scale score (range, 0-27) at 1 month. Secondary outcomes included anxiety (7-item Generalized Anxiety Disorder) and posttraumatic stress disorder (Posttraumatic Stress Scale) symptoms at 1 and 3 months, adherence, and feasibility. General linear models were used to compare main effects and interactions of the components among intervention groups. A formal decisional framework was used to determine an optimized intervention version.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0A total of 247 participants (mean [SD] age, 50.2 [15.4] years; 104 [42.1%] women) were randomized. Twice-daily meditation compared with once-daily meditation was associated with a 1.2 (95% CI, 0.04-2.4)\u2013unit lower mean estimated PHQ-9 score at 1 month and a 1.5 (95% CI, 0.1-2.8)\u2013unit lower estimated mean score at 3 months. The other 2 intervention components had no main effects on the PHQ-9. Across-group adherence was high (217 participants [87.9%] using the intervention at trial conclusion) and retention was strong (191 [77.3%] and 182 [73.7%] at 1 and 3 months, respectively).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>  A mindfulness intervention for survivors of critical illness that included an app-based introduction, twice-daily guided meditation, and app-based management of increasing depression symptoms was optimal considering effects on psychological distress symptoms, adherence, and feasibility.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT04038567<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  May 28, 2024 Mob […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26124"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26124"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26124\/revisions"}],"predecessor-version":[{"id":26467,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26124\/revisions\/26467"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26124"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26124"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26124"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}