Guerrero Estefania, Barrios Maite, Sampietro Hernán María, Aza Alba, Guilera Georgina, Gómez-Benito Juana
Department of Social Psychology and Quantitative Psychology, University of Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Spain.
Department of Social Psychology and Quantitative Psychology, University of Barcelona, Spain; ActivaMent Catalunya Associació, Spain.
Soc Sci Med. 2025 Sep;381:118302. doi: 10.1016/j.socscimed.2025.118302. Epub 2025 Jun 9.
Current public policies emphasize the need for recovery-oriented services. However, a lack of consensus on the meaning of recovery poses challenges for implementing recovery-oriented interventions. This study aims to establish an international consensus on the key elements of recovery from the clinician perspective, specifically from recovery-oriented mental health professionals. A three-round Delphi study was conducted to gather expert opinions on the definition of recovery, progress indicators, and factors that facilitate and hinder recovery. Seventy-eight recovery-oriented professionals agreed to participate and completed a sociodemographic questionnaire after providing informed consent. In the first Delphi round, open-ended questions were used to gather initial opinions, which were analyzed and compiled into a list of statements. In the second and third rounds, participants rated the relevance of each statement using a Likert-type scale. Statements rated as "relevant" or "very relevant" by at least 80 % of participants were considered consensus statements. Recovery was defined as the development of a sense of agency, empowerment, autonomy, and self-determination. Key indicators emphasized agency, empowerment, user safety, and informed decision-making. Facilitators included the promotion of self-determination, a holistic approach within services, and the integration of peer support. Social exclusion emerged as the most significant obstacle to recovery. This study provides an international consensus on the key elements of recovery in mental health from the perspective of recovery-oriented professionals, offering insights for implementing interventions, developing recovery-oriented services, and refining measurement instruments.
当前的公共政策强调需要提供以康复为导向的服务。然而，对于康复的含义缺乏共识给实施以康复为导向的干预措施带来了挑战。本研究旨在从临床医生的角度，特别是从以康复为导向的心理健康专业人员的角度，就康复的关键要素达成国际共识。开展了三轮德尔菲研究，以收集关于康复定义、进展指标以及促进和阻碍康复的因素的专家意见。78名以康复为导向的专业人员在提供知情同意后同意参与并完成了一份社会人口统计学调查问卷。在第一轮德尔菲研究中，使用开放式问题收集初步意见，这些意见经过分析后汇编成一份陈述清单。在第二轮和第三轮中，参与者使用李克特量表对每条陈述的相关性进行评分。至少80%的参与者评为“相关”或“非常相关”的陈述被视为共识陈述。康复被定义为产生一种能动性、赋权、自主性和自我决定权。关键指标强调能动性、赋权、服务对象安全和知情决策。促进因素包括促进自我决定权、服务中的整体方法以及同伴支持的整合。社会排斥成为康复最显著的障碍。本研究从以康复为导向的专业人员的角度就心理健康康复的关键要素达成了国际共识，为实施干预措施、发展以康复为导向的服务以及完善测量工具提供了见解。
