Jambawo Sharon Midzi, Owolewa Rasaq, Jambawo Trevor Tinarwo
Department of Mental Health Nursing, King's College London, 57 Waterloo Road, London SE1 8WA, UK.
Department of Mental Health Nursing, University of West London, St Mary's Road, Earling, London W5 5RF, UK.
Schizophr Res. 2024 Dec;274:270-279. doi: 10.1016/j.schres.2024.10.006. Epub 2024 Oct 17.
People with schizophrenia have a shorter life span and high mortality and morbidity rates. Peer support is an important strategy that can improve outcomes for people with schizophrenia. Peer support involves people with a lived experience of recovery who help and support others experiencing mental health problems.
The main aim of this systematic literature review was to examine the effectiveness of peer support on the recovery and empowerment outcomes of service users with schizophrenia disorders. The objectives were to contribute to evidence-based practice and promote peer support interventions in mental health services.
We searched for randomised controlled trials (RCTs) on peer support in MEDLINE, CINAHL, AMED, Academic Search Premier, PubMed, PsycArticles, PsycINFO, Cochrane, and Psychology and Behavioural Sciences Collection. We identified additional trials from the citations of previous studies.
We assessed the trials' methodological quality and biases using the risk of bias (RoB) and grading of recommendations, assessment, development, and evaluation (GRADE) tools. We performed a meta-analysis in the RevMan application and extracted data from the clinical trials using narrative synthesis. This systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures.
A total of 17 trials with 5974 participants were included in this review. The most common peer support was peer-led self-management interventions. The RE model (SMD = 0.29, 95 % CI = 0.13 to 0.45, p-value = 0.0004) shows that peer support interventions significantly improved the recovery outcome compared to standard care provided to service users with schizophrenia. The RE model (SMD = 0.22, 95 % CI = 0.11 to 0.33, p-value = 0.0001) also shows that peer support interventions significantly empowered service users with schizophrenia. However, the positive effects were small. A sub-group analysis found moderate effects on the recovery outcome among the emerging peer support interventions. The quality of the evidence was moderate.
Peer support interventions effectively improved the recovery and empowerment outcomes. Current clinical trials indicate that peer support is an essential psychosocial intervention in improving empowerment and recovery in service users with schizophrenia.
精神分裂症患者寿命较短，死亡率和发病率较高。同伴支持是一种可改善精神分裂症患者预后的重要策略。同伴支持是指有康复经历的人帮助和支持其他有心理健康问题的人。
本系统文献综述的主要目的是检验同伴支持对精神分裂症患者康复和赋权结果的有效性。目标是为循证实践做出贡献，并在心理健康服务中推广同伴支持干预措施。
我们在MEDLINE、CINAHL、AMED、学术搜索 Premier、PubMed、PsycArticles、PsycINFO、Cochrane以及心理学与行为科学合集数据库中检索了关于同伴支持的随机对照试验（RCT）。我们从先前研究的参考文献中识别出其他试验。
我们使用偏倚风险（RoB）和推荐分级、评估、制定与评价（GRADE）工具评估试验方法学质量及偏倚。我们在RevMan应用程序中进行了荟萃分析，并使用叙述性综合法从临床试验中提取数据。本系统综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）程序。
本综述共纳入17项试验，5974名参与者。最常见的同伴支持是同伴主导的自我管理干预。随机效应模型（标准化均数差=0.29，95%置信区间=0.13至0.45，p值=0.0004）表明，与为精神分裂症患者提供的标准护理相比，同伴支持干预显著改善了康复结果。随机效应模型（标准化均数差=0.22，95%置信区间=0.11至0.33，p值=0.0001）还表明，同伴支持干预显著增强了精神分裂症患者的权能。然而，积极效果较小。亚组分析发现新兴同伴支持干预措施对康复结果有中度影响。证据质量为中等。
同伴支持干预有效改善了康复和赋权结果。当前的临床试验表明，同伴支持是改善精神分裂症患者权能和康复的重要社会心理干预措施。
