학술논문
Barriers and opportunities for implementation of a brief psychological intervention for post-ICU mental distress in the primary care setting - results from a qualitative sub-study of the PICTURE trial
intensive care units
intensive care units
Document Type
Report
Author
Sanftenberg, Linda; Beutel, Antina; Friemel, Chris Maria; Kosilek, Robert Philipp; Schauer, Maggie; Elbert, Thomas; Reips, Ulf-Dietrich; Gehrke-Beck, Sabine; Schubert, Tomke; Schmidt, Konrad; Gensichen, Jochen; Adrion, Christine; Angstwurm, Matthias; Bergmann, Antje; Bielmeier, Gerhard; Bischhoff, Andrea; Bogdanski, Ralph; Brettner, Franz; Brettschneider, Christian; Briegel, Josef; Bürkle, Martin; Dohmann, Johanna; Falkai, Peter; Felbinger, Thomas; Fisch, Richard; Förstl, Hans; Fohr, Benjamin; Franz, Martin; Friederich, Patrick; Gallinat, Jürgen; Gerlach, Herwig; Güldner, Andreas; Hardt, Hanna; Heintze, Christoph; Heinz, Andreas; Heller, Axel; von Heymann, Christian; Hoppmann, Petra; Huge, Volker; Irlbeck, Michael; Jaschinski, Ulrich; Jarczak, Dominik; Joos, Stefanie; Kaiser, Elisabeth; Kerinn, Melanie; Klefisch, Frank-Rainer; Kluge, Stefan; Koch, Roland; Koch, Thea; Kowalski, Michelle; König, Hans-Helmut; Lackermeier, Peter; Laugwitz, Karl-Ludwig; Lemke, Yvonne; Lies, Achim; Linde, Klaus; Lindemann, Daniela; Lühmann, Dagmar; May, Stephanie; Ney, Ludwig; Oltrogge, Jan; Pankow, Wulf; Papiol, Sergi; Ragaller, Maximilian; Rank, Nikolaus; Reill, Lorenz; Richter, Hans-Peter; Riessen, Reimer; Ringeis, Grit; Rüchhardt, Ann; Schelling, Gustav; Schelling, Jörg; Scherag, André; Scherer, Martin; Schneider, Antonius; Schneider, Gerhard; Schneider, Jürgen; Schnurr, Julia; Schultz, Susanne; Schulze, Thomas G; Schumacher, Karin; Spieth, Peter; Thurm, Franka; Vogl, Thomas; Voigt, Karen; Walther, Andreas; Wassilowsky, Dietmar; Wäscher, Cornelia; Weber-Carstens, Steffen; Wehrstedt, Regina; Weierstall-Pust, Roland; Weis, Marion; Weiss, Georg; Well, Harald; Zöllner, Christian; Zwissler, Bernhard
Source
BMC Primary Care. May 6, 2023, Vol. 24 Issue 1
Subject
Language
English
ISSN
2731-4553
Abstract
Author(s): Linda Sanftenberg[sup.1] , Antina Beutel[sup.1] , Chris Maria Friemel[sup.1] , Robert Philipp Kosilek[sup.1] , Maggie Schauer[sup.2] , Thomas Elbert[sup.2] , Ulf-Dietrich Reips[sup.2] , Sabine Gehrke-Beck[sup.3] , Tomke Schubert[sup.3] , [...]
Background The results of critical illness and life-saving invasive measures during intensive care unit treatment can sometimes lead to lasting physical and psychological impairments. A multicentre randomized controlled trial from Germany (PICTURE) aims to test a brief psychological intervention, based on narrative exposure therapy, for post-traumatic stress disorder symptoms following intensive care unit treatment in the primary care setting. A qualitative analysis was conducted to understand feasibility and acceptance of the intervention beyond quantitative analysis of the main outcomes in the primary study. Methods Qualitative explorative sub-study of the main PICTURE trial, with eight patients from the intervention group recruited for semi-structured telephone interviews. Transcriptions were analysed according to Mayring's qualitative content analysis. Contents were coded and classified into emerging categories. Results The study population was 50% female and male, with a mean age of 60.9 years and transplantation surgery being the most frequent admission diagnosis. Four main factors were identified as conducive towards implementation of a short psychological intervention in a primary care setting: 1) long-term trustful relationship between patient and GP team; 2) intervention applied by a medical doctor; 3) professional emotional distance of the GP team; 4) brevity of the intervention. Conclusion The primary setting has certain qualities such as a long-term doctor-patient relationship and low-threshold consultations that offer good opportunities for implementation of a brief psychological intervention for post-intensive care unit impairments. Structured follow-up guidelines for primary care following intensive care unit treatment are needed. Brief general practice-based interventions could be part of a stepped-care approach. Trial registration The main trial was registered at the DRKS (German Register of Clinical Trials: DRKS00012589) on 17/10/2017. Keywords: Post-traumatic stress disorder, Post-intensive care syndrome, Narrative exposure therapy, Qualitative analysis, Mental health
Background The results of critical illness and life-saving invasive measures during intensive care unit treatment can sometimes lead to lasting physical and psychological impairments. A multicentre randomized controlled trial from Germany (PICTURE) aims to test a brief psychological intervention, based on narrative exposure therapy, for post-traumatic stress disorder symptoms following intensive care unit treatment in the primary care setting. A qualitative analysis was conducted to understand feasibility and acceptance of the intervention beyond quantitative analysis of the main outcomes in the primary study. Methods Qualitative explorative sub-study of the main PICTURE trial, with eight patients from the intervention group recruited for semi-structured telephone interviews. Transcriptions were analysed according to Mayring's qualitative content analysis. Contents were coded and classified into emerging categories. Results The study population was 50% female and male, with a mean age of 60.9 years and transplantation surgery being the most frequent admission diagnosis. Four main factors were identified as conducive towards implementation of a short psychological intervention in a primary care setting: 1) long-term trustful relationship between patient and GP team; 2) intervention applied by a medical doctor; 3) professional emotional distance of the GP team; 4) brevity of the intervention. Conclusion The primary setting has certain qualities such as a long-term doctor-patient relationship and low-threshold consultations that offer good opportunities for implementation of a brief psychological intervention for post-intensive care unit impairments. Structured follow-up guidelines for primary care following intensive care unit treatment are needed. Brief general practice-based interventions could be part of a stepped-care approach. Trial registration The main trial was registered at the DRKS (German Register of Clinical Trials: DRKS00012589) on 17/10/2017. Keywords: Post-traumatic stress disorder, Post-intensive care syndrome, Narrative exposure therapy, Qualitative analysis, Mental health