Faculty of Nursing, University of Montréal, Québec, Montréal, Canada.
Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CRIUSMM), Québec, Montréal, Canada.
Int J Ment Health Nurs. 2023 Oct;32(5):1259-1273. doi: 10.1111/inm.13158. Epub 2023 Apr 26.
Crisis situations are frequent among people with mental health disorders. Several interventions have been developed to act in prevention, including crisis plans recognized as particularly effective in reducing coercive measures. In the literature, several models of crisis plans are proposed with similar aims and contents. Based on the methodology proposed by the Joanna Briggs Institute, a scoping review was conducted to map the state of knowledge on crisis plans in adult mental health settings. The literature search conducted on six databases (CINAHL, PubMed, Medline, EMBASE, PsychINFO and Cochrane) yielded 2435 articles. Of these, 122 full-text articles were assessed for eligibility, and 78 met the inclusion criteria. Studies were critically appraised using the Joanna Briggs Institute appraisal tools, and data were extracted by two independent reviewers. Content analysis identified a typology of crisis plans: (1) the legal crisis plan and (2) the formal crisis plan. Five modalities were identified for its completion: the sections, the moment, the completion steps, the people involved and the training of key actors. Most identified outcomes are consistent with the main purpose of the intervention, which is crisis prevention. However, the most identified outcomes focused on the service user's recovery and indicated that crisis plans could provide an opportunity to operationalize recovery in mental healthcare, thus suggesting an evolution in the aim of the intervention. Future research should further focus on the modalities of crisis plans to guide the implementation in clinical practice.
危机情况在心理健康障碍患者中很常见。已经开发了几种干预措施来进行预防，包括危机计划，这些计划被认为在减少强制性措施方面特别有效。在文献中，提出了几种具有相似目的和内容的危机计划模型。基于 Joanna Briggs 研究所提出的方法，进行了范围综述，以绘制成人心理健康环境中危机计划知识的现状图。在六个数据库（CINAHL、PubMed、Medline、EMBASE、PsychINFO 和 Cochrane）中进行的文献检索产生了 2435 篇文章。其中，有 122 篇全文文章符合入选标准，并符合纳入标准。使用 Joanna Briggs 研究所评估工具对研究进行了批判性评估，并且由两名独立评审员提取数据。内容分析确定了危机计划的分类：（1）法律危机计划和（2）正式危机计划。确定了完成计划的五种方式：部分、时刻、完成步骤、涉及的人员和关键人员的培训。大多数确定的结果与干预的主要目的一致，即预防危机。然而，最确定的结果侧重于服务用户的康复，并表明危机计划可以为精神保健中的康复提供机会，从而表明干预目标的演变。未来的研究应进一步关注危机计划的方式，以指导在临床实践中的实施。
