RESUMO
BACKGROUND: Generalized anxiety disorder (GAD) shows the weakest treatment response among anxiety disorders. This study aimed at examining whether an acceptance-based group behavioral therapy (ABBT) for patients in a Brazilian anxiety disorders program, combining mindfulness and exposure strategies, can improve clinical outcome when compared with a standard nondirective supportive group therapy (NDST). METHODS: Ninety-two individuals diagnosed with GAD were randomized to receive 10 sessions of either ABBT or NDST. Assessments at pretreatment, midtreatment, posttreatment, and 3-month follow-up comprised the following outcome measures: Hamilton Anxiety Rating Scale (HAM-A), Penn State Worry Questionnaire (PSWQ), Depression Anxiety and Stress Scale (DASS), and the Clinical Global Impressions (CGI). The World Health Organization Quality of Life (WHOQOL) was administered at pretreatment and posttreatment. RESULTS: The mixed-effects regression models for DASS-stress, Hamilton Anxiety Interview, and CGI showed a significant effect for Time and the Time × Treatment effect, but not for the Treatment main effect. Similarly, there was a significant Time × Treatment effect for the PSWQ, but not main effects of Time or Treatment. Altogether, these data indicate that symptoms decreased in both conditions across treatment and follow-up, and that the rate of change was more rapid for those participants in the ABBT condition. We found no differences between groups from pretreatment to posttreatment in DASS-anxiety or any secondary outcome measure, but for the physical health domain of WHOQOL, which was faster in ABBT. CONCLUSIONS: Both groups showed good clinical outcomes, but in general, participants of the ABBT group improved faster than those in the NDST group.
Assuntos
Psicoterapia de Grupo , Qualidade de Vida , Transtornos de Ansiedade/terapia , Brasil , Humanos , Resultado do TratamentoRESUMO
A comunicação bem-sucedida entre pacientes e clínicos na terapia de suporte aos implantes pode ser comprometida por diversas razões. O objetivo deste trabalho foi apresentar uma nova ferramenta educacional de conhecimento, como o diagrama de motivação por cores (DMC). Com base em uma radiografia periapical feita pela técnica do paralelismo e cone longo, os clínicos podem determinar se os níveis ósseos do paciente estão acima ou abaixo da plataforma do implante. Cálculos simples são feitos entre os anos consecutivos para se determinar o remodelamento ósseo. Depois, o limiar de perda é atribuído para cada intervalo e um código de cores (azul, amarelo, verde ou vermelho) é aplicado. Desta forma, o paciente pode se concentrar nos significados das cores e ter compreensão total dos resultados, além de melhorar sua higiene oral caseira. Embora a validade desta ferramenta ainda não tenha sido investigada cientificamente, ela lança novas perspectivas sobre a motivação do paciente no tratamento com implantes osseointegrados.
Successful communication between patients and clinicians during implant supportive therapy can be compromised due to several reasons. The aim of this paper is to present a new educational tool known as the color motivation chart (CMC). Based on a standardized periapical radiograph using the long-cone technique, clinicians can determine whether the patient shows bone levels above or below the implant platform. Simple calculations are made between consecutive years to determine bone remodeling. After, the threshold value is attributed for each interval and a color code message (blue, yellow, green, and red) is applied. In this way, the patient can concentrate on color meanings and have an overall comprehension of the outcomes and how to improve their oral hygiene home-care measures. Although the validity of this new tool has not been scientifically investigated, it launches new perspectives on patient motivation for implant treatment.