ABSTRACT
BACKGROUND: In order to reduce the high prevalence of depression, early interventions for people at risk of depression are warranted. This study evaluated the effectiveness of an early guided self-help programme based on acceptance and commitment therapy (ACT) for reducing depressive symptomatology. METHOD: Participants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the self-help programme with extensive email support (n=125), the self-help programme with minimal email support (n=125) or to a waiting list control group (n=126). Participants completed measures before and after the intervention to assess depression, anxiety, fatigue, experiential avoidance, positive mental health and mindfulness. Participants in the experimental conditions also completed these measures at a 3-month follow-up. RESULTS: In the experimental conditions significant reductions in depression, anxiety, fatigue, experiential avoidance and improvements in positive mental health and mindfulness were found, compared with the waiting list condition (effect sizes Cohen's d=0.51-1.00). These effects were sustained at the 3-month follow-up. There were no significant differences between the experimental conditions on the outcome measures. CONCLUSIONS: The ACT-based self-help programme with minimal email support is effective for people with mild to moderate depressive symptomatology.
Subject(s)
Behavior Therapy/methods , Depression/prevention & control , Mental Health , Outcome and Process Assessment, Health Care/statistics & numerical data , Self Care/methods , Adaptation, Psychological , Adult , Analysis of Variance , Anxiety/prevention & control , Counseling , Depression/psychology , Depression/therapy , Electronic Mail , Fatigue/prevention & control , Female , Humans , Intention to Treat Analysis , Logistic Models , Male , Middle Aged , Netherlands , Patient Satisfaction , Self Care/psychologyABSTRACT
OBJECTIVE: Natural elements in the built healthcare environment have shown to hold potential stress-reducing properties. In order to shed light on the underlying mechanism of stress-reducing effects of nature, the present study investigates whether the stress-reducing effects of indoor plants occur because such an environment is perceived as being more attractive. METHOD: A single-factor between-subjects experimental design (nature: indoor plants vs. no plants) was used in which participants (n=77) were presented with a scenario describing hospitalization with a possible legionella diagnosis. The study was conducted from March to May 2007 in the Netherlands. Subsequently, they were exposed to a photo of a hospital room. In this room were either indoor plants, or there was a painting of an urban environment on the wall. Afterwards, perceived stress and the perceived attractiveness of the hospital room were measured. RESULTS: Participants exposed to the hospital room with indoor plants reported less stress than those in the control condition. Mediation analysis confirmed that indoor plants in a hospital room reduce feelings of stress through the perceived attractiveness of the room. CONCLUSION: This study confirms the stress-reducing properties of natural elements in the built healthcare environment. It also sheds light on the underlying mechanism causing this stress-reduction.
Subject(s)
Affect , Environment Design , Patients' Rooms , Perception , Plants , Stress, Psychological , Adult , Environmental Health , Facility Design and Construction , Female , Hospitals , Humans , Inpatients/psychology , Interior Design and Furnishings , Male , Netherlands , Sick Building Syndrome/prevention & control , Stress, Psychological/therapy , VentilationABSTRACT
BACKGROUND: Until recently, Dutch general practitioners contributed little to tobacco control. This is due to several factors, among which is the lack of a feasible intervention program for adult smokers. Such a minimal contact behavioral intervention, using the Stage-of-Change concept, is now available. Effectiveness was tested in a randomized trial. METHOD: Twenty-two general practitioners and their practice assistants were trained in applying the program. In all, 530 smoking patients were enrolled, randomly assigned to either the intervention or the usual treatment condition. Analysis of treatment effects was performed with logistic regression analysis. In a backward stepwise procedure confounding effects of baseline differences were eliminated. RESULTS: At 12-month follow-up, self-reported abstinence rates (including nonrespondents as smokers) differed significantly between intervention subjects and controls: 13.4 vs 7.3% point prevalence (odds ratio 1.51, P < 0.05). An analysis of consecutive abstinence, defined as being abstinent at both 6- and 12-month follow-up, showed that 8.2% of the intervention group compared to 3.1% of the controls had sustained abstinence for more than 6 months (odds ratio 3.04, P < 0.001). CONCLUSIONS: Results indicate that an effective smoking cessation program for use in Dutch general practice, already shown to be feasible, is now available. Outcomes are generally consistent with recent international literature.
