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The Effects of App-based Intervention for Depression among Community-dwelling Individuals with Spinal Cord Injury: A Randomized Controlled Trial

  • Author Footnotes
    # Yinnan Liu and Maiwuludai Hasimu contributed equally to this work.
    Yinnan Liu
    Footnotes
    # Yinnan Liu and Maiwuludai Hasimu contributed equally to this work.
    Affiliations
    School of Nursing, Sun Yat-sen University, Guangzhou, China, Address: No.74 Zhong Shan Second Road, Guangzhou 510080, China
    Search for articles by this author
  • Author Footnotes
    # Yinnan Liu and Maiwuludai Hasimu contributed equally to this work.
    Maiwuludai Hasimu
    Footnotes
    # Yinnan Liu and Maiwuludai Hasimu contributed equally to this work.
    Affiliations
    School of Nursing, Sun Yat-sen University, Guangzhou, China, Address: No.74 Zhong Shan Second Road, Guangzhou 510080, China
    Search for articles by this author
  • Mengmeng Jia
    Affiliations
    School of Nursing, Sun Yat-sen University, Guangzhou, China, Address: No.74 Zhong Shan Second Road, Guangzhou 510080, China
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  • Jie Tang
    Affiliations
    Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Chengdu, China, Address: No.81 Ba Yi Road, Chengdu 611135, China
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  • Yingmin Wang
    Affiliations
    Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China, Address: No.107 Yan Jiang West Road, Guangzhou 510120, China
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  • Xiaokuo He
    Affiliations
    Department of Rehabilitation Medicine, The Fifth Hospital of Xiamen, Xiamen, China, Address: No.214 Ma Xiang Road, Xiamen 361101, China
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  • Tiebin Yan
    Affiliations
    Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China, Address: No.107 Yan Jiang West Road, Guangzhou 510120, China
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  • Sumei Xie
    Affiliations
    Department of Spinal Cord Injury Rehabilitation, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China, No.68 Qi De Road, Guangzhou 510440, China
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  • Kun Li
    Correspondence
    Corresponding author: Kun Li, PhD, Associate professor, School of Nursing, Sun Yat-sen University, Guangzhou, China, Address: No.74 Zhong Shan Second Road, Guangzhou 510080, China
    Affiliations
    School of Nursing, Sun Yat-sen University, Guangzhou, China, Address: No.74 Zhong Shan Second Road, Guangzhou 510080, China
    Search for articles by this author
  • Author Footnotes
    # Yinnan Liu and Maiwuludai Hasimu contributed equally to this work.
Published:November 01, 2022DOI:https://doi.org/10.1016/j.apmr.2022.10.005

      Highlights

      • Depression of individuals with SCI will worsen over time without additional support, especially after they discharge from hospitals.
      • Self-management intervention is a potential means to attain long-term benefits on depression in community-dwelling individuals with SCI.
      • APP offers greater possibilities to provide sustainable self-management intervention for community-dwelling individuals with SCI.
      • A longer period of follow-up is needed to observe the long-term effect of App-based self-management intervention on depression.

      Abstract

      Objective

      : To assess the effect of a self-management intervention delivered by mobile application (APP) for depression among community-dwelling individuals with spinal cord injury.

      Design

      : Randomized controlled trial.

      Settings

      : General communities in China.

      Participants

      : Community-dwelling individuals with spinal cord injury who were diagnosed within two years were recruited in this study. It was a convenience sample with an average age of 41.71, 82.7% participants were males.

      Interventions

      : Participants in the intervention group received 5 sessions on self-management training provided by nurse-led multidisciplinary team via APP at the 2nd, 4th, 6th, 8th and 12th weeks respectively after they discharge from hospitals. A routine telephone counselling was provided for each participant in the control group by follow-up nurses at the 12th week after they discharge.

      Outcome measure

      : The outcome of this study is depression, which is not the primary outcomes in the registration of this program. Depression was measured by Beck Depression Inventory (BDI-II) at discharge (T0), the 12th week after discharge from hospitals (T1), and the 24th week after discharge from hospitals (T2).

      Results

      : There were 98 participants (49 in the intervention group and 49 in the control group) completing the intervention and data collection. Compared with the control group, the intervention group had lower level of depression at T2 (B=-5.76; 95% CI= -9.97, -1.54; P =.007). Small to moderate effect sizes on depression favouring the intervention were demonstrated at T1 (Cohen's d=-.178) and T2 (Cohen's d=-.535).

      Conclusions

      : APP-based self-management support can be a potential intervention to reduce depression among community-dwelling individuals with spinal cord injury.

      Key words

      List of abbreviationsAbbreviations:

      SCI (Spinal cord injury), APP (Mobile application), BDI-II (Version 2 of the Beck Depression Inventory)
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