精神疾病中个人康复的概念化、评估和意义:系统评价和荟萃分析的范围综述。

Conceptualizations, assessments, and implications of personal recovery in mental illness: A scoping review of systematic reviews and meta-analyses.

机构信息

Phrenos Center of Expertise.

Department of Psychiatry and Neuropsychology.

出版信息

Psychiatr Rehabil J. 2019 Jun;42(2):169-181. doi: 10.1037/prj0000356. Epub 2019 Mar 7.

Abstract

OBJECTIVE

Recovery, defined as a personal process of living with mental illness, has become a prominent concept in mental health care. We aimed to map the state of the art of conceptualizing recovery, its promoting and impeding factors, recovery-oriented practice, and the assessment of recovery.

METHOD

A scoping review of systematic reviews and meta-analyses was performed. Systematic searches were conducted, supplemented with hand-searching in reference lists.

RESULTS

Of 228 articles that were identified and 33 that were reviewed, a total of 25 were included. This review showed that the CHIME conceptual framework for personal recovery is widely endorsed, containing the elements of connectedness, hope and optimism, identity, meaning in life, and empowerment. Although personal recovery first and foremost starts from individual preferences, the CHIME framework should be adapted according to culture and unique population characteristics. "Difficulties and trauma" should be added, and the person's choice, risk taking, and coping with challenges should be emphasized. Barriers to recovery are stigma and negative effects of mental health services and medication. Facilitators of recovery include spirituality, personal agency, and social support. Recovery-focused interventions, in which peer providers are involved, enhance recovery, hope, and empowerment. For assessing recovery outcomes, multiple instruments are accepted as methodologically sound.

CONCLUSIONS

Personal recovery is conceptualized as complementary to clinical recovery and represents processes rather than outcomes. Additional work is needed to bridge the gap between the concept of recovery-oriented practice and routinely provided interventions. A broad framework of recovery is needed, and more research is needed into the working mechanisms of personal recovery processes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

目的

恢复是指个人带病生存的过程,它已成为精神卫生保健领域的一个重要概念。我们旨在绘制恢复概念、促进和阻碍因素、以恢复为导向的实践以及恢复评估的现状图。

方法

对系统评价和荟萃分析进行了范围综述。系统搜索,辅以参考文献的手工搜索。

结果

在确定的 228 篇文章和 33 篇综述中,共有 25 篇被纳入。这项综述表明,个人恢复的 CHIME 概念框架得到了广泛认可,其中包含了联系、希望和乐观、身份、生活意义和赋权等要素。尽管个人恢复首先源于个人偏好,但 CHIME 框架应根据文化和独特的人口特征进行调整。“困难和创伤”应该被添加进去,并且应该强调个人的选择、冒险和应对挑战的能力。恢复的障碍是耻辱和心理健康服务和药物的负面影响。恢复的促进因素包括灵性、个人能动性和社会支持。以恢复为重点的干预措施,其中包括同伴提供者的参与,增强了恢复、希望和赋权。对于评估恢复结果,多个工具被认为具有合理的方法学基础。

结论

个人恢复被认为是临床恢复的补充,代表的是过程而不是结果。需要做更多的工作来弥合以恢复为导向的实践概念和常规提供的干预措施之间的差距。需要一个广泛的恢复框架,并需要更多的研究来研究个人恢复过程的工作机制。

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