van Busschbach J T, Swildens W, Michon H, Kroon H, Koeter M, Wiersma D, van Os J
Tijdschr Psychiatr. 2016;58(3):179-89.
In the Netherlands the Boston psychiatric rehabilitation approach (bpr) is one of the most widely implemented rehabilitation methods. So far, little research has been done on the efficacy of this approach.
To investigate the effect of bpr on the attainment of personal rehabilitation goals, social functioning and empowerment and on care requirements and quality of life in persons with severe mental illness (smi) in the Netherlands.
In a multicentre randomised controlled trial (rct:
isrctn73683215) patients with smi were randomly assigned to bpr (n = 80) or 'care as usual' (cau; n = 76). The primary outcome was the attainment of the rehabilitation goal as formulated by the patient. The secondary outcomes were a change in the work situation and in the degree of independent living, in care requirements (Camberwell Assessment of Needs), in empowerment (Personal Empowerment Scale) and in the quality of life (who-qol). The effects were tested at 12 and 24 months.
The degree of goal attainment was substantially higher in bpr at both 12 months (adjusted risk difference: 16%; 95%ci, 2 to 31; nnt = 7) and 24 months (adjusted risk difference: 21%, 95%ci, 4% to 38%; nnt = 5). The approach was also more effective in the area of societal participation (bpr: 21% adjusted increase, cau: 0% adjusted increase; nnt = 5), but not in the other secondary outcome measures.
The results suggest that bpr is effective in supporting patients with smi to reach self-formulated rehabilitation goals and in enhancing their societal participation.
在荷兰，波士顿精神病康复方法（bpr）是应用最广泛的康复方法之一。到目前为止，对该方法的疗效研究甚少。
调查bpr对荷兰重症精神疾病（smi）患者实现个人康复目标、社会功能和赋权以及护理需求和生活质量的影响。
在一项多中心随机对照试验（rct：临床试验注册号：isrctn73683215）中，smi患者被随机分配至bpr组（n = 80）或“常规护理”（cau；n = 76）组。主要结局是患者制定的康复目标的实现情况。次要结局包括工作状况、独立生活程度、护理需求（坎伯韦尔需求评估）、赋权（个人赋权量表）和生活质量（who-qol）的变化。在12个月和24个月时测试效果。
在12个月（调整风险差异：16%；95%ci，2%至31%；nnt = 7）和24个月（调整风险差异：21%，95%ci，4%至38%；nnt = 5）时，bpr组的目标达成程度均显著更高。该方法在社会参与方面也更有效（bpr：调整后增加21%，cau：调整后增加0%；nnt = 5），但在其他次要结局指标方面并非如此。
结果表明，bpr在支持smi患者实现自我制定的康复目标以及增强其社会参与方面是有效的。
