Publikation: 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
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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.
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SANFTENBERG, Linda, Antina BEUTEL, Chris Maria FRIEMEL, Robert Philipp KOSILEK, Maggie SCHAUER, Thomas ELBERT, Ulf-Dietrich REIPS, Sabine GEHRKE-BECK, Elisabeth KAISER, Franka THURM, 2023. 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. In: BMC Primary Care. Springer. 2023, 24(1), 113. eISSN 2731-4553. Available under: doi: 10.1186/s12875-023-02046-0BibTex
@article{Sanftenberg2023-05-06Barri-66840, year={2023}, doi={10.1186/s12875-023-02046-0}, title={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}, number={1}, volume={24}, journal={BMC Primary Care}, author={Sanftenberg, Linda and Beutel, Antina and Friemel, Chris Maria and Kosilek, Robert Philipp and Schauer, Maggie and Elbert, Thomas and Reips, Ulf-Dietrich and Gehrke-Beck, Sabine and Kaiser, Elisabeth and Thurm, Franka}, note={Article Number: 113} }
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