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有助于严重精神疾病患者康复的基本要素:一项系统的范围界定研究。

Essential Elements That Contribute to the Recovery of Persons With Severe Mental Illness: A Systematic Scoping Study.

作者信息

Jaiswal Atul, Carmichael Karin, Gupta Shikha, Siemens Tina, Crowley Pavlina, Carlsson Alexandra, Unsworth Gord, Landry Terry, Brown Naomi

机构信息

School of Optometry, Université de Montréal, Montreal, PQ, Canada.

Providence Care, Kingston, ON, Canada.

出版信息

Front Psychiatry. 2020 Nov 19;11:586230. doi: 10.3389/fpsyt.2020.586230. eCollection 2020.

Abstract

There is an increasing emphasis on recovery-oriented care in the design and delivery of mental health services. Research has demonstrated that recovery-oriented services are understood differently depending on the stakeholders involved. Variations in interpretations of recovery lead to challenges in creating systematically organized environments that deliver a consistent recovery-oriented approach to care. The existing evidence on recovery-oriented practice is scattered and difficult to apply. Through this systematic scoping study, we aim to identify and map the essential elements that contribute to recovery outcomes for persons living with severe mental illness. We used the Arksey & O'Malley framework as our guiding approach. Seven key databases (MEDLINE, PubMed, CINAHL/EBSCO, EMBASE, ProQuest, PsycINFO, and Google Scholar) were searched using index terms and keywords relating to recovery and severe mental illness. To be included, studies had to be peer-reviewed, published after 1988, had persons with severe mental illness as the focal population, and have used recovery in the context of mental health. The search was conducted in August 2018 and last updated in February 2020. Out of 4,496 sources identified, sixty ( = 60) sources were included that met all of the selection criteria. Three major elements of recovery that emerged from the synthesis ( = 60) include relationships, sense of meaning, and participation. Some sources ( = 20) highlighted specific elements such as hope, resilience, self-efficacy, spirituality, social support, empowerment, race/ethnicity etc. and their association with the processes underpinning recovery. The findings of this study enable mental health professionals to incorporate the identified key elements into strategic interventions to facilitate recovery for clients with severe mental illness, and thereby facilitate recovery-oriented practice. The review also documents important gaps in knowledge related to the elements of recovery and identifies a critical need for future studies to address this issue.

摘要

在精神卫生服务的设计与提供方面,越来越强调以康复为导向的护理。研究表明,根据所涉及的利益相关者不同,对以康复为导向的服务的理解也有所不同。对康复的不同解读导致在创建系统组织的环境时面临挑战,这些环境要能提供一致的以康复为导向的护理方法。现有的关于以康复为导向的实践的证据分散且难以应用。通过这项系统的范围界定研究,我们旨在识别并梳理出有助于严重精神疾病患者康复结果的关键要素。我们采用阿克西和奥马利框架作为指导方法。使用与康复和严重精神疾病相关的索引词和关键词,对七个关键数据库(MEDLINE、PubMed、CINAHL/EBSCO、EMBASE、ProQuest、PsycINFO和谷歌学术)进行了检索。要纳入研究,必须是经过同行评审的,1988年之后发表的,以严重精神疾病患者为重点人群,并且在精神卫生背景下使用了康复相关内容。检索于2018年8月进行,最后一次更新于2020年2月。在识别出的4496个来源中,有60个来源符合所有选择标准并被纳入。综合分析这60个来源后出现的康复的三个主要要素包括人际关系、意义感和参与度。一些来源(20个)强调了特定要素,如希望、复原力、自我效能感、精神性、社会支持、赋权、种族/民族等,以及它们与康复基础过程的关联。本研究的结果使精神卫生专业人员能够将识别出的关键要素纳入战略干预措施,以促进严重精神疾病患者的康复,从而推动以康复为导向的实践。该综述还记录了与康复要素相关的重要知识空白,并确定了未来研究解决这一问题的迫切需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1060/7710894/8798c3c165b2/fpsyt-11-586230-g0001.jpg

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