Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, HKSAR, China.
Department of Early Childhood Education, Faculty of Education and Human Development, Education University of Hong Kong, Hong Kong, HKSAR, China.
BMJ Open. 2019 May 24;9(5):e026399. doi: 10.1136/bmjopen-2018-026399.
Strengths-based approaches mobilise individual and environmental resources that can facilitate the recovery of people with mental illness. Strengths model case management (SMCM), developed by Rapp and Goscha through collaborative efforts at the University of Kansas, offers a structured and innovative intervention. As evidence of the effectiveness of strengths-based interventions come from Western studies, which lacked rigorous research design or failed to assure fidelity to the model, we aim to fill these gaps and conduct a randomised controlled trial (RCT) to test the effectiveness of SMCM for individuals with mental illness in Hong Kong.
This will be an RCT of SMCM. Assuming a medium intervention effect (Cohen's d=0.60) with 30% missing data (including dropouts), 210 service users aged 18 years or above will be recruited from three community mental health centres. They will be randomly assigned to SMCM groups (intervention) or SMILE groups (control) in a 1:1 ratio. The SMCM groups will receive strengths model interventions from case workers, whereas the SMILE groups will receive generic care from case workers with an attention placebo. The case workers will all be embedded in the community centres and will be required to provide a session with service users in both groups at least once every fortnight. There will be two groups of case workers for the intervention and control groups, respectively. The effectiveness of the SMCM will be compared between the two groups of service users with outcomes at baseline, 6 and 12 months after recruitment. Functional outcomes will also be reported by case workers. Data on working alliances and goal attainment will be collected from individual case workers. Qualitative evaluation will be conducted to identify the therapeutic ingredients and conditions leading to positive outcomes. Trained outcome assessors will be blind to the group allocation.
Ethical approval from the Human Research Ethics Committee at the University of Hong Kong has been obtained (HRECNCF: EA1703078). The results will be disseminated to service users and their families via the media, to healthcare professionals via professional training and meetings and to researchers via conferences and publications.
12617001435370; Pre-results.
基于优势的方法调动个人和环境资源，这可以促进精神疾病患者的康复。由 Rapp 和 Goscha 通过在堪萨斯大学的合作努力开发的优势模型案例管理 (SMCM) 提供了一种结构化和创新的干预措施。由于基于优势的干预措施的有效性来自西方研究，这些研究缺乏严格的研究设计或未能确保对模型的保真度，因此我们旨在填补这些空白，并进行一项随机对照试验 (RCT) 来测试 SMCM 对香港精神疾病患者的有效性。
这将是一项 SMCM 的 RCT。假设中等干预效果（Cohen's d=0.60），有 30%的数据缺失（包括辍学），将从三个社区心理健康中心招募 210 名年龄在 18 岁及以上的服务使用者。他们将以 1:1 的比例随机分配到 SMCM 组（干预组）或 SMILE 组（对照组）。SMCM 组将接受来自个案工作者的优势模型干预，而 SMILE 组将接受个案工作者提供的关注安慰剂的常规护理。个案工作者将全部嵌入社区中心，并要求每两周至少为两组的服务使用者提供一次服务。干预组和对照组将分别有两组个案工作者。将比较两组服务使用者在招募后基线、6 个月和 12 个月的结果。个案工作者还将报告功能结果。将从个别个案工作者收集关于工作联盟和目标实现的数据。将进行定性评估，以确定导致积极结果的治疗成分和条件。经过培训的结果评估人员将对小组分配保持盲态。
香港大学人类研究伦理委员会已获得伦理批准（HRECNCF：EA1703078）。结果将通过媒体向服务使用者及其家属传播，通过专业培训和会议向医疗保健专业人员传播，通过会议和出版物向研究人员传播。
12617001435370；预结果。
