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意大利社区心理健康服务中以康复为导向的实践的可行性、可接受性和影响:一项试点研究

Feasibility, Acceptability, and Impact of Recovery-Oriented Practices in an Italian Community Mental Health Service: A Pilot Study.

作者信息

Martinelli Alessandra, Pozzan Tecla, Procura Elena, D'Astore Camilla, Cristofalo Doriana, Bonetto Chiara, Ruggeri Mirella

机构信息

Unit of Epidemiological Psychiatry and Digital Mental Health, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy.

Section of Psychiatry, Verona Hospital Trust, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.

出版信息

J Clin Med. 2025 Mar 27;14(7):2280. doi: 10.3390/jcm14072280.

Abstract

Over the past decade, Italy has made progress in adopting recovery-oriented approaches in mental health care, though full alignment with international guidelines remains incomplete. This study investigates the feasibility, acceptability, and impact of integrating recovery-oriented practices in an Italian Community Mental Health Service (CMHS), focusing on both user and professional perspectives to identify strengths and areas for improvement. A longitudinal pilot study was conducted at the South Verona CMHS. Data on users' socio-demographic and clinical characteristics, symptoms, functioning, needs, and autonomy were collected at baseline and six-month follow-up. Participants included individuals in supported accommodation and outpatient care. The Mental Health Recovery Star (MHRS) assessed recovery progress. Qualitative data from focus groups and interviews captured users' and professionals' experiences. Nineteen professionals completed the MHRS with 25 users, who demonstrated significant improvements in MHRS scores ( = 0.003), romantic relationships ( < 0.001), employment ( < 0.001), functioning ( = 0.015), psychopathology ( = 0.001), functional autonomy ( = 0.003), and unmet needs ( = 0.026). Qualitative findings emphasized the value of a personalized, holistic approach but noted gaps in follow-up and shared decision-making. Focus groups (30 participants) highlighted recovery as a process of hope, meaning, and empowerment. Participants called for ongoing education, structural changes, and peer-support initiatives. Professionals reported increased motivation. Integrating recovery-oriented practices within the South Verona CMHS was both feasible and acceptable. The MHRS positively impacted service users' personal recovery and professionals' motivation. The study underscores the need for continued training, structural reforms, and peer-support initiatives to foster lasting changes and enhance CMHS practices.

摘要

在过去十年中,意大利在精神卫生保健中采用以康复为导向的方法方面取得了进展,尽管与国际准则的完全接轨仍未完成。本研究调查了在意大利社区精神卫生服务(CMHS)中整合以康复为导向的实践的可行性、可接受性和影响,重点从服务使用者和专业人员的角度来确定优势和改进领域。在南维罗纳社区精神卫生服务中心开展了一项纵向试点研究。在基线期和六个月随访时收集了服务使用者的社会人口学和临床特征、症状、功能、需求及自主性等数据。参与者包括接受支持性住宿和门诊护理的个体。采用心理健康康复之星(MHRS)评估康复进展。焦点小组和访谈的定性数据记录了服务使用者和专业人员的经历。19名专业人员为25名服务使用者完成了MHRS评估,这些使用者在MHRS评分(P = 0.003)、恋爱关系(P < 0.001)、就业(P < 0.001)、功能(P = 0.015)、精神病理学(P = 0.001)、功能自主性(P = 0.003)和未满足的需求(P = 0.026)方面均有显著改善。定性研究结果强调了个性化、整体方法的价值,但也指出了随访和共同决策方面的差距。焦点小组(30名参与者)强调康复是一个充满希望、意义和赋权的过程。参与者呼吁开展持续教育、进行结构变革并推出同伴支持举措。专业人员报告称积极性有所提高。在南维罗纳社区精神卫生服务中心整合以康复为导向的实践是可行且可接受的。MHRS对服务使用者的个人康复和专业人员的积极性产生了积极影响。该研究强调需要持续培训、结构改革和同伴支持举措,以促进持久变革并改进社区精神卫生服务实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12e2/11990030/8a7fbdbd6e1e/jcm-14-02280-g001.jpg

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