A pilot-study to assess the feasibility and acceptability of an Internet-based cognitive-behavior group therapy using video conference for patients with coronary artery heart disease

Tin-Kwang Lin; Pao-Ta Yu; Lian-Yu Lin; Ping-Yen Liu; Yi-Da Li; Chiu-Tien Hsu; Yih-Ru Cheng; Chun-Yin Yeh; Shu-Shu Wong; Shih-An Pai; Huey-Ling Shee; Chia-Ying Weng

doi:10.1371/journal.pone.0207931

A pilot-study to assess the feasibility and acceptability of an Internet-based cognitive-behavior group therapy using video conference for patients with coronary artery heart disease

PLoS One. 2018 Nov 29;13(11):e0207931. doi: 10.1371/journal.pone.0207931. eCollection 2018.

Authors

Tin-Kwang Lin^{1

2}, Pao-Ta Yu³, Lian-Yu Lin⁴, Ping-Yen Liu^{5

6}, Yi-Da Li^{1

2}, Chiu-Tien Hsu⁷, Yih-Ru Cheng⁸, Chun-Yin Yeh⁹, Shu-Shu Wong¹⁰, Shih-An Pai¹¹, Huey-Ling Shee¹², Chia-Ying Weng¹¹

Affiliations

¹ School of Medicine, Tzu Chi University, Hualien, Taiwan.
² Division of Cardiology, Department of Internal Medicine, The Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
³ Department of Computer Science and Information Engineering, National Chung Cheng University, Chiayi, Taiwan.
⁴ Department of Internal Medicine, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan.
⁵ Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan.
⁶ Division of Cardiology, Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
⁷ Center of Clinical Psychology, The Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
⁸ Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan.
⁹ National Cheng Kung University Hospital, Tainan, Taiwan.
¹⁰ Department of Psychology, Wenzhou University, Wenzhou City, China.
¹¹ Department of Psychology, National Chung Cheng University, Chiayi, Taiwan.
¹² College of Law, National Chung Cheng University, Chiayi, Taiwan.

Abstract

Background: Many patients with coronary artery heart disease are unable to access traditional psychosocial rehabilitation conducted face to face due to excessive travel distance. Therefore, this study developed and assessed the feasibility and acceptability of an 8-week Internet-based cognitive-behavior group therapy program, described the patterns of use and measured change in risk factors.

Methods: This study adopted an online video conference system, JointNet, to maintain group interaction functions similar to face to face groups online, and also built an self-learning platform to deliver psychoeducation content and cognitive-behavior therapy related materials and homework. Forty-three out-patients were recruited in the pilot study, who then chose to participate in either the Internet-based cognitive-behavior group therapy or face to face group based on their preference. Fourteen patients were assigned to the waiting-list control.

Results: Seventeen participants (17/43 = 39.5%) chose the Internet-based cognitive-behavior group therapy program. Among them, thirteen participants (13/17 = 76.5%) finished the program and were more male (92.3% vs. 50%), employed (53.8% vs. 35.3%), and had longer education duration (13.9 vs. 12.5 years) than the counterparts of the face to face group. Furthermore, they were highly motivated with average number of log-ins (66.5 time), website surfing time (950.94 min), reading frequency (78.15 time) and reading time (355.90 min) for the self-learning platform during eight weeks; and also highly satisfied (97%) with visiting the self-learning platform and video conferences. The treatment effectiveness of Internet-based cognitive-behavior group therapy was comparable with face to face one in reducing anxiety, hostility, respiration rate, and in improving vasodilation but not depression compared with the waiting-list control.

Conclusion: These results indicated that the Internet-based group therapy program using video conference is feasible and acceptable for the psychosocial rehabilitation of patients with coronary artery heart disease, and provides an alternative for patients who are unable to obtain conventional psychosocial rehabilitation conducted face to face.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anxiety
Cognition
Cognitive Behavioral Therapy / methods*
Coronary Artery Disease / psychology*
Coronary Artery Disease / therapy
Depression
Female
Humans
Internet
Learning
Male
Middle Aged
Pilot Projects
Psychotherapy, Group / methods
Risk Factors
Taiwan
Videoconferencing

Grants and funding

This study was supported by funding from the Ministry of Science and Technology, Taiwan (Grant number: 100-2410-H-194-040-MY2 and the URLs: https://statistics.most.gov.tw/award/) awarded to C-Y W; and The Buddhist Dalin Tzu-Chi General Hospital, Chia-Yi, Taiwan (Grant number: DTCRD-102-E-10 and the URLs:http://dl.tzuchi.com.tw/res/node/163) awarded to Y-D L. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.