Peck Celia Kim Huey, Thangavelu Dhivya Prabha, Li Ziqiang, Goh Yong Shian
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Institute of Mental Health, Singapore, Singapore.
J Psychiatr Ment Health Nurs. 2023 Feb;30(1):54-73. doi: 10.1111/jpm.12853. Epub 2022 Jul 18.
WHAT IS KNOWN ON THE SUBJECT?: The paradigm shifts in the conceptualization of recovery have led to a wide adoption of peer-delivered self-management interventions among individuals with severe and enduring mental health challenges. Peers with experiential knowledge on managing their own mental health conditions act as role models for affected individuals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The meta-analysis demonstrated significant small-to-medium effects favouring such interventions on symptom severity, self-perceived recovery, hopefulness and empowerment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With peer-delivered self-management interventions, individuals with severe and enduring mental health challenges could self-direct their care, thus reducing their reliance on service providers. Individuals with severe and enduring mental health challenges equipped to seek their recovery within the community beyond institutional care, regaining independence and gradually reintegrate into society. ABSTRACT: Introduction The shift in mindset within mental health care has led to the adoption of peer-delivered self-management interventions in promoting recovery among individuals with severe and enduring mental health challenges. However, no reviews have hitherto examined their effectiveness. Aim To determine the effectiveness of peer-delivered self-management interventions in improving symptom severity, self-perceived recovery, hopefulness and empowerment. Method A search was performed in nine English databases for published studies and grey literature from inception to the 5 January 2021. The methodological quality of the studies was graded with the Joanna Briggs Institute's critical appraisal tools. The overall effects were pooled through a meta-analysis with heterogeneity evaluated via the chi-square test and I-square statistics. This review was guided by the PRISMA 2020 statement on transparent reporting of systematic review and meta-analyses. Results Seventeen publications involving 3189 participants were included in this review, and ten were included for the meta-analysis and accounted for 2725 participants. The meta-analysis demonstrated significant small-to-medium effects favouring such interventions on symptom severity, self-perceived recovery, hopefulness and empowerment. Discussion Peer-delivered self-management interventions should be implemented as it is effective in promoting recovery among individuals with severe and enduring mental health challenges. Implications for practice With peer-delivered self-management interventions, individuals with severe and enduring mental health challenges could self-direct their care and reduce their reliance on service providers.
康复概念的范式转变导致同伴提供的自我管理干预措施在患有严重且持久心理健康问题的个体中得到广泛采用。对管理自身心理健康状况有实践经验的同伴为受影响个体树立了榜样。
荟萃分析表明,此类干预措施对症状严重程度、自我感知的康复、希望感和赋权具有显著的小到中等程度的效果。
通过同伴提供的自我管理干预措施,患有严重且持久心理健康问题的个体可以自我指导护理,从而减少对服务提供者的依赖。患有严重且持久心理健康问题的个体有能力在社区而非机构护理环境中寻求康复,重新获得独立并逐渐重新融入社会。
引言 精神卫生保健观念的转变导致采用同伴提供的自我管理干预措施来促进患有严重且持久心理健康问题的个体的康复。然而,迄今为止尚无综述研究其有效性。目的 确定同伴提供的自我管理干预措施在改善症状严重程度、自我感知的康复、希望感和赋权方面的有效性。方法 在九个英文数据库中进行检索,查找从起始到2021年1月5日发表的研究和灰色文献。使用乔安娜·布里格斯研究所的批判性评价工具对研究的方法学质量进行评分。通过荟萃分析汇总总体效应,并通过卡方检验和I²统计量评估异质性。本综述遵循PRISMA 2020关于系统评价和荟萃分析透明报告的声明。结果 本综述纳入了17篇涉及3189名参与者的出版物,其中10篇纳入荟萃分析,涉及2725名参与者。荟萃分析表明,此类干预措施对症状严重程度、自我感知的康复、希望感和赋权具有显著的小到中等程度的效果。讨论 应实施同伴提供的自我管理干预措施,因为它在促进患有严重且持久心理健康问题的个体康复方面是有效的。对实践的启示 通过同伴提供的自我管理干预措施,患有严重且持久心理健康问题的个体可以自我指导护理并减少对服务提供者的依赖。