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促进持续性精神障碍患者的个人康复:一种新型数字干预措施的开发与初步研究

Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention.

作者信息

Thomas Neil, Farhall John, Foley Fiona, Leitan Nuwan Dominic, Villagonzalo Kristi-Ann, Ladd Emma, Nunan Cassy, Farnan Sue, Frankish Rosalie, Smark Tara, Rossell Susan L, Sterling Leon, Murray Greg, Castle David Jonathon, Kyrios Michael

机构信息

Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Monash Alfred Psychiatry Research Centre, Monash University and The Alfred, Melbourne, VIC, Australia.

Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia; NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, VIC, Australia.

出版信息

Front Psychiatry. 2016 Dec 23;7:196. doi: 10.3389/fpsyt.2016.00196. eCollection 2016.

Abstract

BACKGROUND

For people with persisting psychotic disorders, personal recovery has become an important target of mental health services worldwide. Strongly influenced by mental health service consumer perspectives, personal recovery refers to being able to live a satisfying and contributing life irrespective of ongoing symptoms and disability. Contact with peers with shared lived experience is often cited as facilitative of recovery. We aimed to develop and pilot a novel recovery-based digitally supported intervention for people with a psychotic illness.

METHODS

We developed a website to be used on a tablet computer by mental health workers to structure therapeutic discussions about personal recovery. Central to the site was a series of video interviews of people with lived experience of psychosis discussing how they had navigated issues within their own recovery based on the Connectedness-Hope-Identity-Meaning-Empowerment model of recovery. We examined the feasibility and acceptability of an 8-session low intensity intervention using this site in 10 participants with persisting psychotic disorders and conducted a proof-of-concept analysis of outcomes.

RESULTS

All 10 participants completed the full course of sessions, and it was possible to integrate use of the website into nearly all sessions. Participant feedback confirmed that use of the website was a feasible and acceptable way of working. All participants stated that they would recommend the intervention to others. Post-intervention, personal recovery measured by the Questionnaire for the Process of Recovery had improved by an average standardized effect of  = 0.46, 95% CI [0.07, 0.84], and 8 of the 10 participants reported that their mental health had improved since taking part in the intervention.

CONCLUSION

In-session use of digital resources featuring peer accounts of recovery is feasible and acceptable and shows promising outcomes. A randomized controlled trial is the next step in evaluating the efficacy of this low intensity intervention when delivered in conjunction with routine mental health care.

摘要

背景

对于患有持续性精神障碍的人来说,个人康复已成为全球心理健康服务的一个重要目标。个人康复深受心理健康服务消费者观点的影响,是指无论症状和残疾情况如何,都能够过上令人满意且有意义的生活。与有共同生活经历的同龄人接触通常被认为有助于康复。我们旨在为患有精神病性疾病的人开发并试行一种基于康复的新型数字支持干预措施。

方法

我们开发了一个网站,供心理健康工作者在平板电脑上使用,以构建关于个人康复的治疗性讨论。该网站的核心是一系列对有精神病生活经历者的视频访谈,他们根据康复的联系-希望-身份-意义-赋权模型,讨论自己在康复过程中是如何应对各种问题的。我们对10名患有持续性精神障碍的参与者使用该网站进行了为期8节的低强度干预的可行性和可接受性进行了研究,并对结果进行了概念验证分析。

结果

所有10名参与者都完成了全部课程,并且能够将网站的使用几乎整合到所有课程中。参与者的反馈证实,使用该网站是一种可行且可接受的工作方式。所有参与者都表示会向他人推荐这种干预措施。干预后,通过康复过程问卷测量的个人康复平均标准化效应提高了=0.46,95%可信区间[0.07, 0.84],10名参与者中有8人报告称自参加干预以来心理健康状况有所改善。

结论

在课程中使用以同龄人康复经历为特色的数字资源是可行且可接受的,并且显示出有希望的结果。下一步是进行一项随机对照试验,以评估这种低强度干预与常规心理健康护理相结合时的疗效。

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