[Online therapy for depressive disorders : An acceptance-based analysis from the perspective of therapists]. / Onlinetherapie bei depressiven Störungen : Eine Akzeptanzanalyse aus der Perspektive der Behandelnden.

BACKGROUND: The supply of online therapy options for mild to moderate depressive disorders has substantially risen both nationally and internationally in the past years. While the efficacy and efficiency of specific online-based therapeutic services were indicated within the framework of scientific evaluations, little is known about the acceptance of these new therapy options. METHODS: In a nationwide online survey of online-based therapy options for mild to moderate depressive disorders, the attitude and stance as well as the use intention and the subjectively perceived knowledge of 657 medical practitioners and therapists, active in psychotherapeutic and psychiatric treatment were collated. The impact of the potential predictors on the use intention of online-based therapies, based on the unified theory of acceptance and use of technology, was analyzed by means of a binary logistic regression model. RESULTS: Besides the perceived performance and expense expectations, the supportive framework conditions, the influence of the cooperative environment, the individual technical affinity as well as the evaluation of the prospective significance of online-based therapy proved to be significantly influential predictors on the user intention. Special predictability for a positive user intention was shown related to the perceived potential of online therapy. CONCLUSION: The results underline the relevance of further evidence-basing of online therapy for mild to moderate depressive disorders. A user-oriented, participatory technology development proves to be just as relevant as a comprehensive sensitization, elucidation and education of potential users for a successful implementation.

[Acceptance of Online-based Therapy by Patients with Light to Moderate Depressive Disorders]. / Akzeptanz onlinebasierter Therapieangebote bei Patientinnen und Patienten mit leichten bis mittelgradigen depressiven Störungen.

OBJECTIVES: Over the past few years, there has been a considerable increase in online-based therapeutic services for people affected by depressive disorders. The efficacy and efficiency of these programmes is well documented by now. User acceptance is considered as a significant factor of success in establishing this new patient-centered care. Theory-based acceptance surveys can provide valuable scientific knowledge regarding long-term introduction. METHODS: A nationwide online survey was conducted to determine the attitude towards web-based psychotherapy services for depressive disorders, the current state of knowledge and the intention of 186 participants (124 female and 62 male participants; aged 21 and above) to use these services. The participants were recruited from support groups for depressive disorders. The determinants of the intention to use online therapy, which is included in the binary logistic regression, are based upon the Unified Theory of Acceptance and Use of Technology (UTAUT). RESULTS: Nearly two-thirds of the respondents could conceive making use of online-based therapeutic services in the near future. The perceived performance and expected effort proved to be significantly influential predictors regarding the intention to use. Specifically, these included an evaluation of the use of E-Mental Health to assist disease management, and better assessment of the course of one's disease. CONCLUSION: The actual contribution of E-Mental Health is closely connected to technical and jurisprudential assessments. But also, it significantly depends on evidence-based issues as well as user orientation in research, development and implementation. The results offer an initial theory-based approach to an increased user-oriented technology research in health care, with further diversity criteria to be taken into account in the future.

Prevalence and associated psychosocial and health factors of chronic pain in adolescents: Differences by sex and age.

BACKGROUND: Chronic pain is a common issue in adolescents. Prevalence of pain and associated factors present differently in sex and age subgroups; however, the interaction of sex and age combined has not been thoroughly assessed. This study aimed to identify psychosocial and health factors associated with chronic pain in younger and older adolescent girls and boys. METHODS: Students from five schools in grades 5-10 self-completed a pain survey. Participants were 2,280 adolescents (52% girls) aged 10-18 years (M = 12.95, SD = 1.84). Data were analysed using multivariate logistic regression models. RESULTS: Chronic pain was present in 33% of participants. The risk of chronic pain increased by 29% in girls, compared to 16% in boys, per year of age (p = .039). Overall, depression (OR = 2.05, p < .001), anxiety (OR = 1.51, p < .001), lower school satisfaction (OR = 1.41, p = .034) and sleep issues (OR = 2.34, p < .001) were associated with chronic pain. Stratified analyses identified unique significant associations between chronic pain and psychosocial factors. In boys aged 10-13 years, higher socioeconomic status (OR = 1.76, p = .024) and poorer school performance (OR = 1.60, p = .027) were uniquely important; in girls aged 10-13 years, lower school satisfaction (OR = 2.92, p = .003) was associated with pain, and in older girls aged 14-18 years, anxiety (OR = 1.74, p = .009) was significantly associated with pain. When these differences were assessed statistically, only lower school satisfaction had significant differences between subgroups (p = .049). CONCLUSIONS: Many psychosocial and health factors are similarly important, with few differences, for chronic pain in girls and boys at different stages of adolescence. SIGNIFICANCE: We report evidence that negative psychosocial and health factors are related to a higher prevalence of chronic pain in adolescents. Furthermore, the relationships between anxiety, socioeconomic status, lower school satisfaction and lower school performance with pain may vary between adolescents of differing sexes and ages. Understanding how possible risk factors for chronic pain contribute differently to the pain experience of adolescent girls and boys is an important step towards lowering the prevalence of this common health condition.