Department of Psychiatry, University of Illinois at Chicago, 1601 West Taylor Street, Chicago, IL 60612, USA.
Schizophr Bull. 2012 Jun;38(4):881-91. doi: 10.1093/schbul/sbr012. Epub 2011 Mar 14.
The purpose of this study was to determine the efficacy of a peer-led illness self-management intervention called Wellness Recovery Action Planning (WRAP) by comparing it with usual care. The primary outcome was reduction of psychiatric symptoms, with secondary outcomes of increased hopefulness, and enhanced quality of life (QOL). A total of 519 adults with severe and persistent mental illness were recruited from outpatient community mental health settings in 6 Ohio communities and randomly assigned to the 8-week intervention or a wait-list control condition. Outcomes were assessed at end of treatment and at 6-month follow-up using an intent-to-treat mixed-effects random regression analysis. Compared to controls, at immediate postintervention and at 6-month follow-up, WRAP participants reported: (1) significantly greater reduction over time in Brief Symptom Inventory Global Symptom Severity and Positive Symptom Total, (2) significantly greater improvement over time in hopefulness as assessed by the Hope Scale total score and subscale for goal directed hopefulness, and (3) enhanced improvement over time in QOL as assessed by the World Health Organization Quality of Life-BREF environment subscale. These results indicate that peer-delivered mental illness self-management training reduces psychiatric symptoms, enhances participants' hopefulness, and improves their QOL over time. This confirms the importance of peer-led wellness management interventions, such as WRAP, as part of a group of evidence-based recovery-oriented services.
本研究旨在通过比较同伴主导的疾病自我管理干预——“健康康复行动计划(WRAP)”与常规护理,确定其疗效。主要结果是减少精神症状,次要结果是增加希望感和提高生活质量(QOL)。总共从俄亥俄州 6 个社区的门诊社区心理健康机构招募了 519 名患有严重和持续性精神疾病的成年人,并将他们随机分配到 8 周的干预组或等待名单对照组。使用意向治疗混合效应随机回归分析,在治疗结束时和 6 个月随访时评估结果。与对照组相比,在干预后的即刻和 6 个月随访时,WRAP 参与者报告:(1)简明症状量表总体症状严重程度和阳性症状总分随时间的显著减少;(2)希望量表总分和目标定向希望子量表随时间的显著改善;(3)世界卫生组织生活质量-简明量表环境子量表随时间的 QOL 显著改善。这些结果表明,同伴提供的精神疾病自我管理培训可随时间减少精神症状,增强参与者的希望感,并改善他们的 QOL。这证实了同伴主导的健康管理干预的重要性,如 WRAP,作为一系列以康复为导向的循证服务的一部分。