RESUMO
Children with Lyme meningitis are often treated with intravenous ceftriaxone, although oral doxycycline may be effective. Parents were surveyed after observing a video describing a hypothetical Lyme meningitis treatment trial. Eighty-four of 102 (82%) would consent to their child participating. Parents would accept 2 additional days of symptoms (noninferiority margin) with doxycycline even if ceftriaxone hastened symptom resolution.
Assuntos
Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Doxiciclina/uso terapêutico , Consentimento Livre e Esclarecido/psicologia , Neuroborreliose de Lyme/tratamento farmacológico , Pais/psicologia , Administração Intravenosa , Administração Oral , Adolescente , Antibacterianos/administração & dosagem , Ceftriaxona/administração & dosagem , Criança , Ensaios Clínicos como Assunto , Pesquisa Comparativa da Efetividade , Doxiciclina/administração & dosagem , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Doença de Lyme/complicações , Doença de Lyme/tratamento farmacológico , Inquéritos e Questionários , Resultado do TratamentoRESUMO
OBJECTIVES: Discuss initial findings of a randomized clinical trial comparing the effects of telephone-based and face-to-face (f-to-f) cognitive-behavioral therapy (CBT) on changes in caregiver (CG) burden, assistance support, depression, and health status for African American (AA) CGs with depression. DESIGN: Pilot study using a prepost, two-group design with 14 enrolled and randomized participants. MEASURES: Subjective Burden subscale of the Caregiver Appraisal Inventory, Assistance Support subscale of the Interpersonal Support Evaluation List, Physical Symptoms subscale of the Caregiver Health and Health Behavior Inventory and the Center for Epidemiologic Studies Depression Scale. RESULTS: Prepost improvements were found on 11 completers across all measures for both telephone and f-to-f CBT. Moderate and similar effects sizes for CG subjective burden and assistance support were found for both the telephone and f-to-f groups. Effect sizes for physical symptoms and depression varied from low to moderate, respectively, with a trend toward smaller improvements in f-to-f CBT than in telephone CBT. Qualitative analysis highlighted CGs' perceptions of the active ingredients of treatment and provided indirect support for similar gains in emotional and psychosocial functioning across the two treatment modalities. CONCLUSIONS: Both telephone-based and f-to-f CBT showed improvements in depression, subjective burden, and assistance support in dementia AA CGs. Replication with a larger sample size (N = 106) is currently in progress. Study limitations and future directions for research are also addressed.