TY - JOUR AU - Norlund, Fredrika AU - Wallin, Emma AU - Olsson, Erik Martin Gustaf AU - Wallert, John AU - Burell, Gunilla AU - von Essen, Louise AU - Held, Claes PY - 2018 DA - 2018/03/08 TI -近期心肌梗死患者抑郁和焦虑症状的基于互联网的认知行为治疗:U-CARE心脏随机对照试验JO - J Med Internet Res SP - e88 VL - 20 IS - 3kw - eHealth KW -治疗依从性和依从性KW -患者接受保健KW -患者选择KW -心脏康复AB -背景:抑郁和焦虑症状在心肌梗死(MI)后很常见。基于互联网的认知行为疗法(iCBT)在其他患者群体中显示出良好的效果。目的:本研究的目的是评估iCBT治疗减少近期心肌梗死患者自我报告的抑郁和焦虑症状的有效性。方法:总共筛选了25家瑞典医院的3928名患者。在这些患者中，239名(33.5%，80/239名女性，平均年龄60岁)近期有心肌梗死和抑郁或焦虑症状的患者被随机分配到治疗师指导的14周iCBT治疗组(n=117)或常规治疗组(TAU;n = 122)。iCBT治疗是为心肌梗死后患者设计的。主要结局是基线后14周的医院焦虑和抑郁量表(HADS)总分，通过互联网评估。治疗效果评价依据意向-治疗原则，采用多重归责法。在主要分析中，在控制年龄、性别和基线HADS的情况下，估计了联合治疗效果。 Results: There was a reduction in HADS scores over time in the total study sample (mean delta=−5.1, P<.001) but no difference between the study groups at follow-up (beta=−0.47, 95% CI −1.95 to 1.00, P=.53). Treatment adherence was low. A total of 46.2% (54/117) of the iCBT group did not complete the introductory module. Conclusions: iCBT treatment for an MI population did not result in lower levels of symptoms of depression or anxiety compared with TAU. Low treatment adherence might have influenced the result. Trial Registration: ClinicalTrials.gov NCT01504191; https://clinicaltrials.gov/ct2/show/NCT01504191 (Archived at Webcite at http://www.webcitation.org/6xWWSEQ22) SN - 1438-8871 UR - //www.mybigtv.com/2018/3/e88/ UR - https://doi.org/10.2196/jmir.9710 UR - http://www.ncbi.nlm.nih.gov/pubmed/29519777 DO - 10.2196/jmir.9710 ID - info:doi/10.2196/jmir.9710 ER -