针对有严重精神疾病亲身经历者的数字同伴支持心理健康干预措施：系统评价
Digital Peer Support Mental Health Interventions for People With a Lived Experience of a Serious Mental Illness: Systematic Review.
作者信息
Fortuna Karen L, Naslund John A, LaCroix Jessica M, Bianco Cynthia L, Brooks Jessica M, Zisman-Ilani Yaara, Muralidharan Anjana, Deegan Patricia
机构信息
Dartmouth College, Lebanon, NH, United States.
Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States.
出版信息
JMIR Ment Health. 2020 Apr 3;7(4):e16460. doi: 10.2196/16460.
BACKGROUND
Peer support is recognized globally as an essential recovery service for people with mental health conditions. With the influx of digital mental health services changing the way mental health care is delivered, peer supporters are increasingly using technology to deliver peer support. In light of these technological advances, there is a need to review and synthesize the emergent evidence for peer-supported digital health interventions for adults with mental health conditions.
OBJECTIVE
The aim of this study was to identify and review the evidence of digital peer support interventions for people with a lived experience of a serious mental illness.
METHODS
This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures. The PubMed, Embase, Web of Science, Cochrane Central, CINAHL, and PsycINFO databases were searched for peer-reviewed articles published between 1946 and December 2018 that examined digital peer support interventions for people with a lived experience of a serious mental illness. Additional articles were found by searching the reference lists from the 27 articles that met the inclusion criteria and a Google Scholar search in June 2019. Participants, interventions, comparisons, outcomes, and study design (PICOS) criteria were used to assess study eligibility. Two authors independently screened titles and abstracts, and reviewed all full-text articles meeting the inclusion criteria. Discrepancies were discussed and resolved. All included studies were assessed for methodological quality using the Methodological Quality Rating Scale.
RESULTS
A total of 30 studies (11 randomized controlled trials, 2 quasiexperimental, 15 pre-post designs, and 2 qualitative studies) were included that reported on 24 interventions. Most of the studies demonstrated feasibility, acceptability, and preliminary effectiveness of peer-to-peer networks, peer-delivered interventions supported with technology, and use of asynchronous and synchronous technologies.
CONCLUSIONS
Digital peer support interventions appear to be feasible and acceptable, with strong potential for clinical effectiveness. However, the field is in the early stages of development and requires well-powered efficacy and clinical effectiveness trials.
TRIAL REGISTRATION
PROSPERO CRD42020139037; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID= 139037.
背景
同伴支持在全球范围内被公认为是为患有精神疾病的人提供的一项重要康复服务。随着数字心理健康服务的涌入改变了心理健康护理的提供方式，同伴支持者越来越多地利用技术来提供同伴支持。鉴于这些技术进步，有必要审查和综合针对患有精神疾病的成年人的同伴支持数字健康干预措施的新出现证据。
目的
本研究的目的是识别和审查针对有严重精神疾病生活经历者的数字同伴支持干预措施的证据。
方法
本系统评价采用系统评价和Meta分析的首选报告项目（PRISMA）程序进行。在PubMed、Embase、Web of Science、Cochrane Central、CINAHL和PsycINFO数据库中检索1946年至2018年12月期间发表的经同行评审的文章，这些文章研究了针对有严重精神疾病生活经历者的数字同伴支持干预措施。通过搜索符合纳入标准的27篇文章的参考文献列表以及2019年6月的谷歌学术搜索，又发现了其他文章。采用参与者、干预措施、对照、结局和研究设计（PICOS）标准来评估研究的合格性。两位作者独立筛选标题和摘要，并审查所有符合纳入标准的全文文章。讨论并解决了分歧。使用方法学质量评定量表对所有纳入研究的方法学质量进行评估。
结果
共纳入30项研究（11项随机对照试验、2项半实验性研究、15项前后设计研究和2项定性研究），这些研究报告了24种干预措施。大多数研究证明了点对点网络、技术支持的同伴提供的干预措施以及异步和同步技术的使用的可行性、可接受性和初步有效性。
结论
数字同伴支持干预措施似乎是可行和可接受的，具有很强的临床有效性潜力。然而，该领域仍处于发展初期，需要有充足样本量的疗效和临床有效性试验。
试验注册
PROSPERO CRD42020139037；https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID= 139037。
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