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促进精神病障碍患者的社区参与:一种新的基于同伴主导的摄影心声干预的有效性。

Fostering the community participation of individuals with psychiatric disabilities: Effectiveness of a new peer-led photovoice-based intervention.

机构信息

Center for Psychiatric Rehabilitation, Sargent College, Boston University.

出版信息

Psychiatr Rehabil J. 2023 Sep;46(3):196-210. doi: 10.1037/prj0000540. Epub 2023 Mar 30.

Abstract

OBJECTIVE

Having meaningful social roles and full community participation have been examined as a central tenet of the recovery paradigm. We undertook this study to test a new multimodal, peer-led intervention, which we have developed with the aim of fostering the self-efficacy of individuals with psychiatric disabilities to pursue involvement in community activities of their choice.

METHOD

We evaluated the effectiveness of the 6-month manualized peer-delivered "Bridging Community Gaps Photovoice (BCGP)" program with a multisite randomized trial ( = 185), with recipients of services at five community mental health programs. Mixed-effects regression models were used to examine the impact of the program on community participation, loneliness, personal stigma, psychosocial functioning, and personal growth and recovery when compared to services as usual. Individuals who were randomized to the BCGP intervention were also invited to participate in exit focus groups, exploring the program's perceived active ingredients of mechanisms of impact.

RESULTS

Participation in the BCGP program facilitated ongoing involvement in community activities and contributed to a decreased sense of alienation from other members of the community due to internalized stigma of mental illness. In addition, greater attendance of group BCGP sessions had a significant impact on participants' sense of self-efficacy in pursuing desired community activities.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

This study provided initial evidence about the promise of the BCGP program in enhancing community participation. Its implementation in community mental health agencies can further expand the recovery-oriented services provided to people with psychiatric disabilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

目的

有意义的社会角色和充分的社区参与已被视为康复模式的核心原则。我们进行这项研究是为了测试一种新的多模式、同伴主导的干预措施,我们开发这种干预措施的目的是培养精神病残疾个体追求参与他们选择的社区活动的自我效能。

方法

我们使用多站点随机试验(n=185)评估了 6 个月的手册化同伴提供的“弥合社区差距摄影(BCGP)”计划的有效性,该计划的接受者来自五个社区心理健康计划的服务对象。混合效应回归模型用于检查与常规服务相比,该计划对社区参与、孤独感、个人耻辱感、心理社会功能以及个人成长和康复的影响。随机分配到 BCGP 干预组的个体还被邀请参加退出焦点小组,探讨该计划对影响机制的感知积极因素。

结果

参与 BCGP 计划有助于个体持续参与社区活动,并减少因内化的精神疾病耻辱感而与社区其他成员疏远的感觉。此外,更多地参加小组 BCGP 会议对参与者追求期望的社区活动的自我效能感有显著影响。

结论和对实践的意义

这项研究提供了关于 BCGP 计划在增强社区参与方面的前景的初步证据。在社区心理健康机构实施该计划可以进一步扩大为精神病残疾个体提供的以康复为导向的服务。

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