{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T07:49:09Z","timestamp":1769672949714,"version":"3.49.0"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"crossref","award":["DFG Grant: GE 2073\/8-1"],"award-info":[{"award-number":["DFG Grant: GE 2073\/8-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosmentalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Ment Health"],"abstract":"<jats:p>There is currently a gap in the follow-up care of patients with post-traumatic stress disorder (PTSD) after intensive care. Long-term care is mainly provided within the setting of general practice. A conversation-based brief intervention carried out by general practitioners improved the symptoms of mild to moderate post-traumatic stress disorder sustainably. The aim of this study is to assess the subjective effectiveness and feasibility of short-term, primary care-based narrative exposure intervention from the perspective of participating general practitioners. Process-accompanying follow-up calls were made to all general practitioners in the intervention group to check the feasibility of the intervention and to reinforce the initial training. The survey was conducted by telephone between the second and third intervention sessions using an open-response questionnaire. The data analysis was carried out using the structuring qualitative content analysis according to Kuckartz. A total of N\u2009=\u200993 protocols from 87 general practitioners were analyzed. The intervention was assessed as useful and effective by most general practitioners. Nearly half of respondents considered permanent implementation in everyday practice, another third with certain limitations. The good learnability and practicability of the intervention as well as the patient\u2019s need were cited as beneficial factors. The greatest barriers to feasibility were seen in the high time expenditure and the lack of remuneration in standard care. Given the shortage of follow-up care for post-ICU PTSD symptoms and the substantial waiting times for trauma-focused psychotherapy, this low-threshold intervention delivered by general practitioners appears both feasible and well-positioned to help bridge a critical gap in care. Since the general practitioners surveyed emphasized the advantage of a quick and low-threshold treatment option for the care of patients with symptoms of PTSD after a stay on an intensive care unit, it seems sensible to ensure that general practitioners have access to training opportunities in the future. Additionally, diagnostics for Post-Intensive Care Syndrome should be implemented after intensive care.<\/jats:p>","DOI":"10.1371\/journal.pmen.0000467","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T18:34:06Z","timestamp":1769625246000},"page":"e0000467","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmen.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of a conversation-based brief intervention in general practice to reduce post-traumatic symptoms after intensive care treatment\u2014A qualitative analysis of the PICTURE study"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0912-2993","authenticated-orcid":true,"given":"Antina","family":"Beutel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris 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Clinical trial protocol: PICTURE \u2013 PTSD after ICU survival. Caring for patients with traumatic stress sequelae. A multi-center, observer-blinded, randomized, controlled trial with a psychological intervention. 2019."},{"issue":"1","key":"pmen.0000467.ref014","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1186\/s13063-018-2853-7","article-title":"Effect of a combined brief narrative exposure therapy with case management versus treatment as usual in primary care for patients with traumatic stress sequelae following intensive care medicine: study protocol for a multicenter randomized controlled trial (PICTURE)","volume":"19","author":"J Gensichen","year":"2018","journal-title":"Trials"},{"issue":"6","key":"pmen.0000467.ref015","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"pmen.0000467.ref016","volume-title":"Qualitative Inhaltsanalyse","author":"U Kuckartz","year":"2018","edition":"4"},{"key":"pmen.0000467.ref017","doi-asserted-by":"crossref","DOI":"10.1026\/03097-000","volume-title":"Narrative Expositionstherapie (NET)","author":"F Neuner","year":"2021"},{"issue":"4","key":"pmen.0000467.ref018","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/HRP.0000000000000136","article-title":"The Prevalence of Posttraumatic Stress Disorder in Primary Care: A Systematic Review","volume":"25","author":"M Spottswood","year":"2017","journal-title":"Harv Rev Psychiatry"},{"issue":"4","key":"pmen.0000467.ref019","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/nicc.12165","article-title":"Post-ICU symptoms, consequences, and follow-up: an integrative review","volume":"22","author":"H Svenningsen","year":"2017","journal-title":"Nurs Crit Care"},{"key":"pmen.0000467.ref020","first-page":"420","article-title":"Collaborative and stepped care for depression: Development of a model project within the Hamburg Network for Mental Health (psychenet.de)","volume":"58","author":"M H\u00e4rter","year":"2015","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"issue":"2","key":"pmen.0000467.ref021","article-title":"Case-Management bei Panikst\u00f6rung in der Hausarztpraxis: Eine qualitative Patientenbefragung","volume":"98","author":"K Lukaschek","year":"2022","journal-title":"Z Allg Med"},{"issue":"6","key":"pmen.0000467.ref022","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1159\/000365114","article-title":"Dissemination of psychotherapy for trauma spectrum disorders in postconflict settings: a randomized controlled trial in Rwanda","volume":"83","author":"N Jacob","year":"2014","journal-title":"Psychother Psychosom"},{"issue":"4","key":"pmen.0000467.ref023","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1037\/0022-006X.76.4.686","article-title":"Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: a randomized controlled trial","volume":"76","author":"F Neuner","year":"2008","journal-title":"J Consult Clin Psychol"},{"key":"pmen.0000467.ref024","volume-title":"Praxishandbuch Narrative Trauma-Arbeit (NAT)","author":"E Kaiser","year":"2026"},{"issue":"1","key":"pmen.0000467.ref025","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s12875-023-02046-0","article-title":"Barriers and opportunities for implementation of a brief psychological intervention for post-ICU mental distress in the primary care setting - results from a qualitative sub-study of the PICTURE trial","volume":"24","author":"L Sanftenberg","year":"2023","journal-title":"BMC Prim Care"}],"container-title":["PLOS Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmen.0000467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T18:34:12Z","timestamp":1769625252000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pmen.0000467"}},"subtitle":[],"editor":[{"given":"Karli","family":"Montague-Cardoso","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pmen.0000467","relation":{},"ISSN":["2837-8156"],"issn-type":[{"value":"2837-8156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]}}}