Mousavizadeh Seyedeh Narjes, Jandaghian Bidgoli Mohammad Amin
Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Psychiatry. 2023 Jul;18(3):332-351. doi: 10.18502/ijps.v18i3.13013.
New initiatives are needed to manage patients with mental health problems in the community. Among the core principal ideals of any healthcare system is transition from traditional services to community-based practices. The aim of this study was to assess community-based and recovery-oriented practices and interventions for individuals with mental health problems. MESH keywords, including "mental health recovery", "rehabilitation", "aftercare", "community psychiatry", and "mental health service" were searched in scientific databases such as Medline, EMBASE, PsychInfo, CINAHL, and Cochrane up to July 2022. A snowball search was also conducted on eligible studies. The methodological quality of the studies was determined by Kmet standard criteria. The systematic review included 32 studies, all of which demonstrated a moderate to high promising effect for community-based and recovery-oriented practices or programs on patients with severe mental illness. These practices could help patients to find suitable jobs, avoid isolation and stigma, improve communication skills, increase awareness of problems, and foster independence. The study also highlighted the pivotal role of nurses, artistic and sports activities, electronic (E)-mental health, home visits, psychoeducation, and special recovery programs. Community-based and recovery-oriented practices should be used as an effective means of normalizing the lives of psychiatric patients. In essence, by cultivating hope and empowering these patients, many of the concerns of health systems can be eradicated.
需要采取新举措来管理社区中患有精神健康问题的患者。任何医疗保健系统的核心主要理念之一是从传统服务向基于社区的实践转变。本研究的目的是评估针对有精神健康问题的个人的基于社区和以康复为导向的实践与干预措施。在诸如Medline、EMBASE、PsychInfo、CINAHL和Cochrane等科学数据库中检索了截至2022年7月的与“精神健康康复”、“康复”、“后续护理”、“社区精神病学”和“精神健康服务”等相关的医学主题词。还对符合条件的研究进行了滚雪球式检索。研究的方法学质量由Kmet标准准则确定。该系统评价纳入了32项研究,所有这些研究均表明基于社区和以康复为导向的实践或项目对重症精神疾病患者具有中度到高度的积极效果。这些实践可以帮助患者找到合适的工作、避免孤立和污名化、提高沟通技巧、增强问题意识并促进独立性。该研究还强调了护士、艺术和体育活动、电子(E)-心理健康、家访、心理教育以及特殊康复项目的关键作用。基于社区和以康复为导向的实践应被用作使精神病患者生活正常化的有效手段。从本质上讲,通过培养希望并赋予这些患者权力,可以消除卫生系统的许多担忧。