Background

Adults with cystic fibrosis (awCF) have higher levels of depression and anxiety than community samples. The Coping and Learning to Manage Stress with CF (CALM) intervention was developed for awCF reporting elevated symptoms of depression or anxiety.

Methods

In this pilot study, awCF were randomly assigned to either six telehealth sessions (CALM; n = 15) or treatment-as-usual (TAU; n = 16). Primary outcomes were depression and anxiety. Secondary outcomes were coping self-efficacy and health-related quality of life (HrQOL). Tertiary outcomes were feasibility, acceptability, and satisfaction. Assessments were completed at baseline, post-intervention, and 3-month follow-up. Group differences were examined via independent samples t-tests. Effect size (ES) was calculated via Cohen's d to provide a measure of the magnitude of the treatment effect.

Results

At post-intervention, the CALM group had a lower mean score than the TAU group for depression (medium ES) and anxiety (large ES). The CALM group had higher (i.e., better) mean scores than the TAU group for coping (large ES) and HrQOL domains of Social Functioning (large ES) and Vitality (large ES). Most treatment gains were not sustained at 3-month follow-up. CALM was feasible, requiring <12 min. for setup and scheduling, and allowed seamless participation when hospitalized. Mean scores for acceptability and satisfaction indicated that most participants either agreed or strongly agreed that CALM was acceptable and satisfactory.

Conclusions

CALM shows promise as an intervention to reduce symptoms of depression and anxiety and improve coping and HrQOL. Next steps are to add a booster session and examine CALM via a multi-site RCT.

中文翻译：

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远程医疗干预的试点 RCT，以减轻患有囊性纤维化的成年人的抑郁和焦虑症状

背景

与社区样本相比，患有囊性纤维化 (awCF) 的成年人的抑郁和焦虑水平更高。使用 CF 应对和学习管理压力 (CALM) 干预措施是为 awCF 报告抑郁或焦虑症状升高而开发的。

方法

在这项试点研究中，awCF 被随机分配到六个远程医疗会议（CALM；n  = 15）或照常治疗（TAU；n  = 16）。主要结果是抑郁和焦虑。次要结果是应对自我效能和健康相关的生活质量（HrQOL）。三级结果是可行性、可接受性和满意度。在基线、干预后和 3 个月的随访中完成了评估。通过独立样本 t 检验检查组差异。通过 Cohen's d计算效果大小 (ES)以提供治疗效果大小的量度。

结果

在干预后，CALM 组的抑郁（中等 ES）和焦虑（大 ES）的平均得分低于 TAU 组。在应对（大 ES）和 HrQOL 领域的社会功能（大 ES）和活力（大 ES）方面，CALM 组的平均得分高于（即更好）。大多数治疗收益在 3 个月的随访中并未持续。CALM 是可行的，需要 <12 分钟。用于设置和调度，并允许在住院时无缝参与。可接受性和满意度的平均分数表明，大多数参与者同意或强烈同意 CALM 是可以接受和令人满意的。

结论

CALM 有望作为一种干预措施来减轻抑郁和焦虑症状并改善应对和 HrQOL。接下来的步骤是添加一个助推器会话并通过多站点 RCT 检查 CALM。