Quiles C, Renelleau C, Douriez E, Verdoux H
Centre hospitalier Charles-Perrens, 33000 Bordeaux, France; University Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, 33000 Bordeaux, France.
Établissement public de Santé mentale de la Marne, 51100 Reims, France.
Encephale. 2022 Dec;48(6):674-681. doi: 10.1016/j.encep.2022.01.009. Epub 2022 Aug 13.
The effectiveness of programs integrating trained and paid peer helpers on symptoms, quality of life and recovery of persons with bipolar disorder or schizophrenia is still poorly understood. The factors influencing the integration of peer helpers into healthcare teams are also poorly understood.
A systematic review of the literature was performed. We systematically searched multiple electronic databases for articles: (i) exploring the effectiveness of the intervention of trained and paid peer helpers in bipolar disorder and schizophrenia (ii) reporting barriers and facilitators to the integration of peer helpers.
Forty-eight articles were included, 24 on the effectiveness of the intervention of peer helpers, 18 on barriers and 13 on facilitators to the integration of peer helpers in health teams. Of them, 25 were based upon qualitative methods (7 concerning the effectiveness of the intervention of peer helpers, 14 the barriers and 7 the facilitators to their integration); 23 were based upon quantitative methods (9 studies focused on the effectiveness of peer helper intervention, 2 on barriers and 6 on integration facilitators). The 23 quantitative studies included 8 randomized controlled trials.
In spite of their heterogeneity, the results suggest that that interventions of peer helpers have a positive impact on the recovery, quality of life, social functioning, physical health and clinical outcome of persons with bipolar disorder or schizophrenia. The results also showed that the integration of peer helpers is favored by caregivers' awareness about the role of peer helpers and knowledge about the recovery model. The results highlight the need for peer helpers to have a well-defined role and to be supervised, preferably by another peer helper.
将经过培训且有报酬的同伴辅助者纳入项目对双相情感障碍或精神分裂症患者的症状、生活质量和康复的有效性仍知之甚少。影响同伴辅助者融入医疗团队的因素也鲜为人知。
进行了一项系统的文献综述。我们系统地在多个电子数据库中搜索文章：（i）探索经过培训且有报酬的同伴辅助者对双相情感障碍和精神分裂症干预的有效性（ii）报告同伴辅助者融入的障碍和促进因素。
纳入了48篇文章，24篇关于同伴辅助者干预的有效性，18篇关于障碍，13篇关于同伴辅助者融入医疗团队的促进因素。其中，25篇基于定性方法（7篇关于同伴辅助者干预的有效性，14篇关于障碍，7篇关于其融入的促进因素）；23篇基于定量方法（9项研究关注同伴辅助者干预的有效性，2项关于障碍，6项关于融入促进因素）。这23项定量研究包括8项随机对照试验。
尽管结果存在异质性，但表明同伴辅助者干预对双相情感障碍或精神分裂症患者的康复、生活质量、社会功能、身体健康和临床结局有积极影响。结果还表明，同伴辅助者的融入受到护理人员对同伴辅助者角色的认识以及对康复模式的了解的促进。结果强调同伴辅助者需要有明确的角色并接受监督，最好由另一名同伴辅助者进行监督。
