Spectrum Centre for Mental Health Research, School of Health and Medicine, Lancaster University, Lancaster, LA1 4YT, UK.
BMC Psychiatry. 2011 Jun 16;11:100. doi: 10.1186/1471-244X-11-100.
Mental health problems commonly begin in adolescence when the majority of people are living with family. This can be a frightening time for relatives who often have little knowledge of what is happening or how to manage it. The UK National Health Service has a commitment to support relatives in order to reduce their distress, but research studies have shown that this can lead to a better outcome for service users as well. Unfortunately, many relatives do not get the kind of support they need. We aim to evaluate the feasibility, acceptability and effectiveness of providing and supporting a Relatives' Education and Coping Toolkit (REACT) for relatives of people with recent onset psychosis.
The study is a randomised control trial. Trial Registration for Current Controlled Trials ISRCTN69299093. Relatives of people receiving treatment from the Early Intervention Service for psychosis are randomly allocated to receive either Treatment As Usual (TAU) or TAU plus the REACT intervention. The main aims of the study are to: (i) determine the acceptability of a supported self-management intervention; (ii) determine preference for type of support; (iii) assess the feasibility of the design; (iv) identify the barriers and solutions to offering support for self-management approaches within the NHS; (v) estimate the likely effect size of the impact of the intervention on outcome for relatives; (vi) gain detailed feedback about the barriers and solutions to using a self-management approach; (vii) describe the way in which the intervention is used. Outcomes will be assessed from baseline and at 6 month follow-up.
The intervention is compared to current treatment in a sample of participants highly representative of relatives in routine early intervention services across the UK. The intervention is protocolised, offered within routine practice by existing staff and extensive process data is being collected. Randomisation is independent; all assessments are made by blind raters. The limitations of the study are the lack of control over how the intervention is delivered, the short follow-up period, and the lack of assessment of service user outcomes. Despite these, the findings will inform future effectiveness trials and contribute to the growing evidence base for supported self-mangement interventions in mental health.
心理健康问题通常在青少年时期开始，此时大多数人都与家人一起生活。这对亲属来说可能是一个可怕的时期，他们通常对正在发生的事情或如何处理这些事情知之甚少。英国国民保健制度承诺支持亲属，以减轻他们的痛苦，但研究表明，这也可以为服务使用者带来更好的结果。不幸的是，许多亲属没有得到他们所需要的支持。我们旨在评估为近期发病的精神病患者的亲属提供和支持“亲属教育和应对工具包（REACT）”的可行性、可接受性和有效性。
该研究是一项随机对照试验。试验在当前对照试验注册处进行，注册号为 ISRCTN69299093。从精神病早期干预服务中接受治疗的患者的亲属被随机分配接受常规治疗（TAU）或 TAU 加 REACT 干预。该研究的主要目的是：（i）确定支持自我管理干预的可接受性；（ii）确定对支持类型的偏好；（iii）评估设计的可行性；（iv）确定在国民保健制度内提供自我管理支持方法的障碍和解决方案；（v）估计干预对亲属结果的影响的可能效应大小；（vi）获得关于使用自我管理方法的障碍和解决方案的详细反馈；（vii）描述干预的使用方式。从基线和 6 个月随访时评估结果。
该干预措施与参与者样本中的常规早期干预服务中的亲属的当前治疗方法进行比较，该参与者样本具有代表性。该干预措施是方案化的，由现有工作人员在常规实践中提供，并收集了大量的过程数据。随机分组是独立的；所有评估都是由盲评人员进行的。该研究的局限性在于无法控制干预措施的实施方式、随访时间短以及缺乏对服务使用者结果的评估。尽管存在这些局限性，但研究结果将为未来的有效性试验提供信息，并为支持精神卫生中的自我管理干预措施的不断增长的证据基础做出贡献。
