Coulombe Simon, Radziszewski Stephanie, Meunier Sophie, Provencher Hélène, Hudon Catherine, Roberge Pasquale, Provencher Martin D, Houle Janie
Department of Psychology, Université du Québec à Montréal, Montréal QC, Canada.
Faculty of Nursing, Université Laval, Québec City QC, Canada.
Front Psychol. 2016 Apr 26;7:584. doi: 10.3389/fpsyg.2016.00584. eCollection 2016.
A shift toward person-centered care has been occurring in services provided to people with mood and anxiety disorders. Recovery is recognized as encompassing personal aspects in addition to clinical ones. Guidelines now recommend supporting people's engagement in self-management as a complementary recovery avenue. Yet the literature lacks evidence on how individualized combinations of self-management strategies used by people relate to their clinical and personal recovery indicators.
The aims of this study were to identify profiles underlying mental health recovery, describe the characteristics of participants corresponding to each profile, and examine the associations of profiles with criterion variables.
149 people recovering from anxiety, depressive, or bipolar disorders completed questionnaires on self-management, clinical recovery (symptom severity), personal recovery (positive mental health), and criterion variables (personal goal appraisal, social participation, self-care abilities, coping).
Latent profile analysis (LPA) revealed three profiles. The Floundering profile included participants who rarely used self-management strategies and had moderately severe symptoms and the lowest positive mental health. The Flourishing profile was characterized by frequent use of self-empowerment strategies, the least severe symptoms, and the highest positive mental health. Participants in the Struggling profile engaged actively in several self-management strategies focused on symptom reduction and healthy lifestyle. They concomitantly reported high symptom severity and moderately high positive mental health. The study revealed that Floundering was associated with higher probabilities of being a man, being single, and having a low income. People in the Flourishing profile had the most favorable scores on criterion variables, supporting the profiles' construct validity.
The mixed portrait of Struggling participants on recovery indicators suggests the relationship between health engagement and recovery is more intricate than anticipated. Practitioners should strive for a holistic understanding of their clients' self-management strategies and recovery indicators to provide support personalized to their profile. While people presenting risk factors would benefit from person-centered support, societal efforts are needed in the long term to reduce global health inequalities. The integration of constructs from diverse fields (patient-centered care, chronic illness, positive psychology) and the use of person-oriented analysis yielded new insights into people's engagement in their health and well-being.
在为患有情绪和焦虑障碍的人提供的服务中,正发生着向以患者为中心的护理模式的转变。康复被认为不仅包括临床方面,还涵盖个人层面。现在的指南建议支持人们参与自我管理,将其作为一种辅助康复途径。然而,文献中缺乏关于人们使用的自我管理策略的个性化组合如何与其临床和个人康复指标相关的证据。
本研究的目的是确定心理健康康复的潜在模式,描述与每种模式相对应的参与者特征,并检验模式与标准变量之间的关联。
149名从焦虑症、抑郁症或双相情感障碍中康复的人完成了关于自我管理、临床康复(症状严重程度)、个人康复(积极心理健康)和标准变量(个人目标评估、社会参与、自我护理能力、应对方式)的问卷调查。
潜在类别分析(LPA)揭示了三种模式。“挣扎”模式包括很少使用自我管理策略、症状中度严重且积极心理健康水平最低的参与者。“蓬勃发展”模式的特点是频繁使用自我赋权策略、症状最不严重且积极心理健康水平最高。“奋斗”模式的参与者积极参与多种旨在减轻症状和促进健康生活方式的自我管理策略。他们同时报告症状严重程度较高且积极心理健康水平中等偏高。研究表明,“挣扎”模式与男性、单身和低收入的可能性较高相关。“蓬勃发展”模式的人在标准变量上得分最有利,支持了模式的结构效度。
“奋斗”模式参与者在康复指标上的复杂情况表明,健康参与和康复之间的关系比预期更为复杂。从业者应努力全面了解客户的自我管理策略和康复指标,以便提供符合其模式的个性化支持。虽然存在风险因素的人将从以患者为中心的支持中受益,但从长远来看,需要社会努力来减少全球健康不平等。整合来自不同领域(以患者为中心的护理、慢性病、积极心理学)的概念并使用以人为本的分析方法,为人们参与自身健康和幸福提供了新的见解。