CORE: Copenhagen Research for Mental Health, Gentofte Hospitalsvej 15, 3A, 2900, Hellerup, Denmark.
Department of Health Sciences, Centre of Evidence-Based Psychosocial Interventions, CEPI, Lund University, Lund, Sweden.
BMC Psychiatry. 2023 Jun 6;23(1):406. doi: 10.1186/s12888-023-04875-w.
Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities.
To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery.
In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up.
Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes.
We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness.
The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.
活动和参与对于健康和幸福至关重要。目前关于如何支持精神病患者参与日常活动的证据有限。
调查有意义的活动和康复（MA&R）的有效性，这是一种由同伴主导的职业治疗干预措施，侧重于活动参与、功能、生活质量和个人康复。
在一项由丹麦 7 家社区和市立精神卫生服务机构的 139 名参与者参与的、由统计学家盲法的、多中心 RCT 中，参与者被随机分配到 1）MA&R 和标准精神卫生保健或 2）标准精神卫生保健。MA&R 干预持续 8 个月，包括 11 次小组会议、11 次个体会议和支持参与活动。主要结局指标是活动参与度，使用严重精神疾病患者职业参与概况（POES-S）进行测量。在基线和干预后随访时测量结局。
MA&R 以高保真度交付，83%的参与者完成了干预。与标准精神卫生保健相比，它没有显示出优越性，因为意向治疗分析显示，两组在活动参与度或任何次要结局方面均无显著差异。
我们没有发现 MA&R 的积极效果，可能是由于 COVID-19 及相关限制。保真度评估和依从率表明，MA&R 是可行且可接受的。然而，未来的研究应该在研究其有效性之前，专注于改进干预措施。
该试验于 2019 年 5 月 24 日在 ClinicalTrials.gov 注册，编号为 NCT03963245。
