Informační a komunikační technologie představují nové a slibné kanály, jak lze k uživatelům doručit intervence založené na Mindfulness přístupu. Běžným problémem v této oblasti aplikovaného výzkumu je nedostatek evidence o adherenci ke zmíněným programům. Aktuální článek ve formě systematické review podle PRISMA protokolu shrnuje informace o tom, jaká je adherence k intervencím ve studiích zabývajících se eHealth Mindfulness programy, jak je adherence měřena a co jsou její možné prediktory. V databázích PubMed, Web of Science, Medline, Scopus a PsychINFO bylo do konce roku 2019 identifikováno 3104 potenciálně relevantních článků. Vzhledem k očekávanému nárůstu implementace eHealth programů na podporu duševního zdraví pro zdravou i klinickou populaci v důsledku pandemie SARS-CoV-2, se stávající review zabývala jen studiemi před začátkem pandemie. 69 z nich splnilo všechna vstupní kritéria pro systematickou review. 61 % studií ve svých výsledcích prezentovalo různé parametry adherence, 36 % pak prezentovalo základní tzv. adherence rate. Míra adherence v klinických populacích se pohybovala od 41 % do 92 %; v neklinických populacích se pohybovala od 1 % do 85 %. Prediktory adherence byly zkoumány ve 48 % studií, většina hodnocených proměnných však přinesla značně heterogenní výsledky. Velká heterogenita byla pozorována také v samotné definici adherence a ve způsobech a nástrojích jejího měření. Aktuální systematická review jednoznačně dokládá potřebu standardizovaného systému měření adherence a dalšího výzkumu v oblasti jejích prediktorů.
Information and communication technology are promising channels in delivering the mindfulness-based intervention. A common problem in these interventions is the lack of study of treatment adherence. The current article summarizes the state of measuring and reporting adherence, the rate of adherence, and possible predictors of adherence in the form of a systematic review following the PRISMA statement. A database search of PubMed, Web of Science, Medline, Scopus, and PsychINFO identified 3104 potentially relevant articles published up to the end of December 2019. The review focuses only on the SARS-CoV-2 pre-pandemic time because the accelerated development of the eHealth Mindfulness-based interventions and a vast amount of newly published interventions in the following years was expected. A total of 69 studies met all the eligibility criteria. Out of these studies, 61% reported some measure of adherence and 36% reported the adherence rate. The adherence rate in clinical populations ranged from 41% to 92%; in non-clinical populations, it ranged from 1% to 85%. Predictors of adherence were investigated in 48% of the studies; however, the majority of assessed variables had mixed findings about predicting adherence. There was a huge variety in the definitions and measurements of adherence. A standardized system of measuring and reporting adherence and further investigation of its predictors is needed.
Treatment specificity and adherence to treatment manuals represent essential components of the medical model in psychotherapy. The model assumes that psychotherapists who work with the same type of clients and who identify with the same theoretical approach work very similarly. This study illustrates the shortcomings of that assumption and explores how therapists' individuality forms and shapes their unique approaches that resonate with their own personalities, inclinations, and worldviews. Semi-structured interviews with eight Gestalt therapists working with clients who experienced medically unexplained physical symptoms were analysed using the grounded theory method. Considerable differences were found among the therapists within four domains of the personal therapeutic approach, namely Case Conceptualization, Therapeutic Task, Therapist's Position, and Alternative Strategy. However, regardless of the differences, all the therapists endeavoured, either implicitly or explicitly, to convey to the clients what they considered to be healthy functioning. There is considerable diversity in the way therapists work even when they subscribe to the same psychotherapeutic approach and work with the same type of clients. The exploration of psychotherapists' usual strategies, as well as the alternative strategies they use when their usual strategies do not work, appears helpful for capturing their personal therapeutic approaches.
- Publikační typ
- časopisecké články MeSH
