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由同伴支持工作者在新冠疫情期间推动的在线及以康复为导向的支持小组:一项可行性前后对照研究方案

Online and Recovery-Oriented Support Groups Facilitated by Peer Support Workers in Times of COVID-19: Protocol for a Feasibility Pre-Post Study.

作者信息

Pelletier Jean-Francois, Houle Janie, Goulet Marie-Hélène, Juster Robert-Paul, Giguère Charles-Édouard, Bordet Jonathan, Hénault Isabelle, Lesage Alain, De Benedictis Luigi, Denis Frédéric, Ng Roger

机构信息

Department of Psychiatry and Addictology, Montreal Mental Health University Institute - Research Centre, University of Montreal, Montreal, QC, Canada.

Department of Psychiatry, Yale University, New Haven, CT, United States.

出版信息

JMIR Res Protoc. 2020 Dec 18;9(12):e22500. doi: 10.2196/22500.

Abstract

BACKGROUND

In times of pandemics, social distancing, isolation, and quarantine have precipitated depression, anxiety, and substance misuse. Scientific literature suggests that patients living with mental health problems or illnesses (MHPIs) who interact with peer support workers (PSWs) experience not only the empathy and connectedness that comes from similar life experiences but also feel hope in the possibility of recovery. So far, it is the effect of mental health teams or programs with PSWs that has been evaluated.

OBJECTIVE

This paper presents the protocol for a web-based intervention facilitated by PSWs. The five principal research questions are whether this intervention will have an impact in terms of (Q1) personal-civic recovery and (Q2) clinical recovery, (Q3) how these recovery potentials can be impacted by the COVID-19 pandemic, (Q4) how the lived experience of persons in recovery can be mobilized to cope with such a situation, and (Q5) how sex and gender considerations can be taken into account for the pairing of PSWs with service users beyond considerations based solely on psychiatric diagnoses or specific MHPIs. This will help us assess the impact of PSWs in this setting.

METHODS

PSWs will lead a typical informal peer support group within the larger context of online peer support groups, focusing on personal-civic recovery. They will be scripted with a fixed, predetermined duration (a series of 10 weekly 90-minute online workshops). There will be 2 experimental subgroups-patients diagnosed with (1) psychotic disorders (n=10) and (2) anxiety or mood disorders (n=10)-compared to a control group (n=10). Random assignment to the intervention and control arms will be conducted using a 2:1 ratio. Several instruments will be used to assess clinical recovery (eg, the Recovery Assessment Scale, the Citizenship Measure questionnaire). The COVID-19 Stress Scales will be used to assess effects in terms of clinical recovery and stress- or anxiety-related responses to COVID-19. Changes will be compared between groups from baseline to endpoint in the intervention and control groups using the Student paired sample t test.

RESULTS

This pilot study was funded in March 2020. The protocol was approved on June 16, 2020, by the Research Ethics Committees of the Montreal Mental Health University Institute. Recruitment took place during the months of July and August, and results are expected in December 2020.

CONCLUSIONS

Study results will provide reliable evidence on the effectiveness of a web-based intervention provided by PSWs. The investigators, alongside key decision makers and patient partners, will ensure knowledge translation throughout, and our massive open online course (MOOC), The Fundamentals of Recovery, will be updated with the evidence and new knowledge generated by this feasibility study.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04445324; https://clinicaltrials.gov/ct2/show/NCT04445324.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/22500.

摘要

背景

在疫情期间,社交距离、隔离和检疫引发了抑郁、焦虑和药物滥用问题。科学文献表明,患有精神健康问题或疾病(MHPIs)的患者与同伴支持工作者(PSWs)互动时,不仅能感受到来自相似生活经历的同理心和联系,还能对康复的可能性抱有希望。到目前为止,评估的是有PSWs参与的精神健康团队或项目的效果。

目的

本文介绍了一项由PSWs推动的基于网络的干预方案。五个主要研究问题是,该干预在以下方面是否会产生影响:(问题1)个人-公民康复;(问题2)临床康复;(问题3)这些康复潜力如何受到新冠疫情的影响;(问题4)如何调动康复者的生活经历来应对这种情况;(问题5)在将PSWs与服务使用者配对时,如何在仅基于精神科诊断或特定MHPIs的考虑之外,兼顾性别因素。这将有助于我们评估PSWs在这种情况下的影响。

方法

PSWs将在更大规模的在线同伴支持小组背景下,领导一个典型的非正式同伴支持小组,重点关注个人-公民康复。他们将按照固定的、预先确定的时长编写脚本(一系列为期10周、每周90分钟的在线工作坊)。将有两个实验亚组——被诊断患有(1)精神障碍(n = 10)和(2)焦虑或情绪障碍(n = 10)的患者——与一个对照组(n = 10)进行比较。将以2:1的比例随机分配到干预组和对照组。将使用多种工具来评估临床康复情况(例如,康复评估量表、公民身份测量问卷)。新冠压力量表将用于评估在临床康复以及对新冠疫情的压力或焦虑相关反应方面的效果。使用学生配对样本t检验,比较干预组和对照组从基线到终点的组间变化。

结果

这项试点研究于2020年3月获得资助。该方案于2020年6月16日获得蒙特利尔大学精神卫生研究所研究伦理委员会的批准。招募工作在7月和8月进行,预计2020年12月得出结果。

结论

研究结果将为PSWs提供的基于网络的干预的有效性提供可靠证据。研究人员将与关键决策者和患者伙伴一道,确保始终进行知识转化,我们的大规模开放在线课程(MOOC)“康复基础”将根据这项可行性研究产生的证据和新知识进行更新。

试验注册

ClinicalTrials.gov NCT0​​4445324;https://clinicaltrials.gov/ct2/show/NCT04445324。

国际注册报告识别码(IRRID):PRR1-10.2196/22500。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82c4/7752185/6d92b2f0bcf1/resprot_v9i12e22500_fig1.jpg

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