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随机对照试验:一项针对从医院过渡到社区的精神分裂症个体的简短同伴支持干预。

Randomized trial of a brief peer support intervention for individuals with schizophrenia transitioning from hospital to community.

机构信息

University of Toronto Department of Psychiatry, Canada.

Ryerson University, Department of Psychology, Canada.

出版信息

Schizophr Res. 2021 May;231:214-220. doi: 10.1016/j.schres.2021.03.019. Epub 2021 Apr 22.

Abstract

This phase 2 randomized trial examined the outcomes of a brief, transitional, peer support intervention designed to address the poor outcomes that are common for individuals with schizophrenia spectrum illnesses in the period immediately following hospitalization. In the context of treatment-as-usual, participants were provided with a peer support intervention, 'the Welcome Basket,' in which participants received 1-2 sessions of peer support in the two weeks before discharge and met weekly for a month post-discharge. The study also piloted a brief version of this intervention with only one community session post-discharge with the same pre-discharge process. It was hypothesized that the full intervention would improve community transition outcomes, with community functioning (Multnomah Community Ability Scale) being the primary measure and secondary measures including symptomatology, community integration, personal recovery, quality of life, and social support. The examination of the brief intervention was exploratory. Measures were completed at baseline, 1-month post-discharge, and follow-up at 6 months. A total of 110 participants were randomized to one of three interventions, with outcome data obtained from 82 and follow-up from 74. While feasible, we did not find that the Welcome Basket intervention was superior to treatment as usual for any of our primary or secondary outcome measures. Future work is needed to determine whether a more extended intervention is required and whether specific subgroups of patients may benefit (e.g. those without access to immediate psychiatric care or those better able to engage with a peer).

摘要

这项 2 期随机试验研究了一种短暂的过渡性同伴支持干预的结果,该干预旨在解决精神分裂谱系疾病患者在住院后立即面临的预后不良问题。在常规治疗的背景下,参与者接受了同伴支持干预,即“欢迎包”,在出院前的两周内接受 1-2 次同伴支持,并在出院后的一个月内每周会面一次。该研究还试用了一种简化版的干预措施,仅在出院后进行一次社区会议,采用与预出院阶段相同的流程。研究假设,完整的干预措施将改善社区过渡结果,以社区功能(Multnomah 社区能力量表)作为主要测量指标,次要测量指标包括症状、社区融入、个人康复、生活质量和社会支持。对简短干预措施的检查是探索性的。参与者在基线、出院后 1 个月和 6 个月时完成测量。共有 110 名参与者被随机分配到三种干预措施之一,其中 82 名参与者获得了结果数据,74 名参与者获得了随访数据。虽然可行,但我们没有发现“欢迎包”干预措施在任何主要或次要结果测量指标上优于常规治疗。需要进一步研究确定是否需要更长期的干预措施,以及特定的患者亚组是否可能受益(例如,那些无法立即获得精神科护理的患者,或那些更能与同伴互动的患者)。

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