School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK.
Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt.
BMC Psychiatry. 2021 Dec 6;21(1):607. doi: 10.1186/s12888-021-03614-3.
People with psychosis report experiences of highly traumatic events. Positive change or post-traumatic growth (PTG) can occur as a result of traumatic experiences. Yet there is limited attention on PTG in psychosis, possibly due to the negative impact of psychotic symptoms on functioning and quality of life. The aim of this review was to identify significant correlates and mediators of PTG in psychosis, and to develop a conceptual framework synthesising facilitators of PTG in psychosis.
Ten electronic databases were searched in seven languages, and five journals and grey literature were searched in English. Quantitative studies were eligible if examining correlates, mediators, or the temporal relationship between PTG and one or more variables. Qualitative studies were eligible if describing PTG arising from experiences of psychosis. Findings from quantitative papers were grouped by analysis method, with significant correlates, mediators, and temporal relationships descriptively reported upon. Narrative synthesis was conducted on findings in qualitative papers.
Thirty-seven papers were included. Significant correlates and mediators of PTG were identified. Mediators of PTG in psychosis included meaning in life, coping self-efficacy, core beliefs, and self-reported recovery. No studies describing the temporal relationship between PTG and psychosis were identified. The narrative synthesis identified seven facilitators of PTG in psychosis: Personal identity and strength, Receiving support, Opportunities and possibilities, Strategies for coping, Perspective shift, Emotional experience, and Relationships, giving the acronym PROSPER.
Individuals with psychosis can be supported to grow from traumatic experiences. Clinicians can support PTG through the provision of trauma-informed care that supports positively valued identity changes. For researchers, the findings provide an evidence-based theoretical framework for conceptualising PTG, which can be validated through longitudinal cohort studies and underpin the development of new clinical interventions.
精神病患者会报告经历过高度创伤性事件。创伤后成长（PTG）可能会因创伤经历而发生。然而，精神病学领域对 PTG 的关注有限，这可能是由于精神病症状对功能和生活质量的负面影响。本研究旨在确定精神病患者 PTG 的显著相关因素和中介因素，并制定一个综合精神病患者 PTG 促进因素的概念框架。
在七种语言中搜索了 10 个电子数据库，并在英语中搜索了 5 种期刊和灰色文献。如果研究考察了 PTG 与一个或多个变量之间的相关性、中介因素或时间关系，则定量研究符合条件。如果描述了精神病经历引起的 PTG，则定性研究符合条件。定量论文的研究结果按分析方法分组，对显著的相关性、中介因素和时间关系进行描述性报告。对定性论文的研究结果进行了叙述性综合。
共纳入 37 篇论文。确定了精神病患者 PTG 的显著相关因素和中介因素。精神病患者 PTG 的中介因素包括生活意义、应对自我效能感、核心信念和自我报告的康复情况。没有发现描述 PTG 与精神病之间时间关系的研究。叙述性综合确定了精神病患者 PTG 的七个促进因素：个人身份和力量、获得支持、机会和可能性、应对策略、观点转变、情感体验和人际关系，简称 PROSPER。
精神病患者可以从创伤经历中得到支持，实现成长。临床医生可以通过提供创伤知情护理来支持 PTG，这种护理可以支持有价值的身份变化。对于研究人员来说，这些发现为概念化 PTG 提供了一个基于证据的理论框架，可以通过纵向队列研究进行验证，并为新的临床干预措施提供依据。
