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拉丁美洲国家严重精神疾病患者的综合康复和重返工作岗位:REINTEGRA 研究方案。

Comprehensive rehabilitation and job reintegration of people with severe mental illness in a Latin American country: REINTEGRA study protocol.

机构信息

Jalisco Institute of Mental Health, SALME, Guadalajara, Mexico.

University of Guadalajara, University Center of Health Sciences, Guadalajara, Mexico.

出版信息

BMC Psychiatry. 2023 Jun 19;23(1):446. doi: 10.1186/s12888-023-04835-4.

Abstract

BACKGROUND

Despite the increasing use of comprehensive rehabilitation models for people with severe mental illness (SMI), there are still limitations to their implementation and replicability in a consensual way, particularly in Latin American countries. The REINTEGRA program aims to be a standardized model of comprehensive rehabilitation focused on psychosocial and cognitive improvement through a set of interventions on different areas of people's functionality, with the goal of reintegrating people with SMI into the labour market. In this paper we summarize the protocol for its subsequent implementation in a mental health institution in Mexico.

METHOD

The protocol is based on a quasi-experimental, prospective longitudinal study, with a pragmatic or naturalistic control group. It will be carried out in three phases. Phase 1 consists of a series of interventions focused on psychosocial improvement; Phase 2 focuses on cognitive and behavioral improvement treatments; and Phase 3 targets psychosocial recovery through rehabilitation and reintegration into the labour market. The overall procedure will be monitored with standarized evaluations at different stages of the program.

DISCUSSION

This study presents a model of integral rehabilitation of people with SMI. At the moment, one of the obstacles to overcome is the organization and procedural control of the different actors needed for its implementation (nurses, psychologists, doctors, companies, institutions, etc.). REINTEGRA will be the first comprehensive rehabilitation model that includes systematized procedures for job reinsertion for people with SMI in Mexico, which aims to be a standardized tool of easy adaptation and the replicability for other mental health centers and institutions.

摘要

背景

尽管越来越多地使用综合康复模式来治疗严重精神疾病 (SMI) 患者,但这些模式在共识基础上的实施和可复制性仍然存在局限性,特别是在拉丁美洲国家。REINTEGRA 计划旨在成为一种标准化的综合康复模式,通过一系列针对人们功能不同领域的干预措施,重点关注心理社会和认知改善,目标是使患有 SMI 的人重新融入劳动力市场。本文总结了该计划随后在墨西哥一家心理健康机构实施的方案。

方法

该方案基于一项准实验、前瞻性纵向研究,具有实用或自然主义的对照组。它将分三个阶段进行。第一阶段包括一系列侧重于心理社会改善的干预措施;第二阶段侧重于认知和行为改善治疗;第三阶段通过康复和重新融入劳动力市场来实现心理社会康复。整个过程将通过在方案的不同阶段进行标准化评估来进行监测。

讨论

本研究提出了一种治疗 SMI 患者的整体康复模式。目前,需要克服的障碍之一是为其实施所需的不同参与者的组织和程序控制(护士、心理学家、医生、公司、机构等)。REINTEGRA 将是墨西哥第一个将工作重新融入的综合康复模式纳入系统程序的模式,旨在成为一种标准化的易于适应和复制的工具,适用于其他心理健康中心和机构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8344/10278265/6aeea0a3a8ea/12888_2023_4835_Fig1_HTML.jpg

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