Sjöberg André, Liv Per, Lindström Maria
Department of Epidemiology and Global Health, Umeå University, Umeå, Västerbotten County, Sweden
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Västerbotten County, Sweden.
BMJ Ment Health. 2025 Aug 7;28(1):e301757. doi: 10.1136/bmjment-2025-301757.
Individuals with serious mental illness (SMI) living in supported accommodation often lead lonely and sedentary lives. Everyday Life Rehabilitation (ELR) is a collaborative, person-centred, activity-oriented and recovery-oriented intervention that integrates outreach rehabilitation efforts into routine practices. This intervention aims to enhance personal recovery and quality of life by promoting engagement in meaningful everyday activities within real-life contexts.
To evaluate the effectiveness of ELR on personal recovery and quality of life among residents with SMI in supported accommodation, compared with treatment-as-usual (TAU).
This was a pragmatic, parallel-group, cluster-randomised controlled trial (RCT) (NCT05056415) conducted in Sweden between August 2021 and June 2024. The RCT included 60 housing units (clusters) randomly assigned (1:1) to receive either ELR or TAU. Data were collected by independent, blinded assessors, with partial blinding of residents. The primary outcome, Recovering Quality of Life (ReQoL-20), was assessed at the individual level and analysed using a mixed-effects model and an intention-to-treat (ITT) approach by a statistician blinded to the allocation.
Participants in the intervention group showed significantly greater improvements in ReQoL scores at 6 months compared with the control group (20.1, 95% CI: 15.8 to 24.4), with a statistically significant between-group difference (p<0.001). The ITT analysis included 60 housing units with 161 participants (86 men and 72 women), of whom 90 were allocated to ELR (33 units) and 71 to TAU (27 units). The overall attrition rate was 24% in both groups, and no major adverse events were reported.
These findings indicate that ELR is an effective intervention with a clinically relevant impact on recovering quality of life for individuals with SMI living in supported accommodation. While these results should be interpreted within the context of the Swedish system, they contribute to the growing body of evidence supporting recovery-oriented and activity-oriented interventions in supported accommodation.
Responsive, person-centred, goal-oriented activity training, grounded in collaborative alliance, represents a valid strategy for recovery-oriented interventions. While multilevel approaches must be tailored to specific contexts, the integration of occupational therapists may provide clinical benefits in supported accommodation.
NCT05056415.
居住在支持性住所中的严重精神疾病（SMI）患者往往过着孤独且久坐不动的生活。日常生活康复（ELR）是一种协作式、以人为本、以活动为导向且以康复为导向的干预措施，它将外展康复工作融入日常实践中。该干预旨在通过促进在现实生活环境中参与有意义的日常活动来提高个人康复水平和生活质量。
与常规治疗（TAU）相比，评估ELR对居住在支持性住所中的SMI患者个人康复和生活质量的有效性。
这是一项于2021年8月至2024年6月在瑞典进行的务实、平行组、整群随机对照试验（RCT）（NCT05056415）。该RCT包括60个住房单元（整群），随机分配（1:1）接受ELR或TAU。数据由独立的、盲法评估者收集，居民部分设盲。主要结局指标，即生活质量恢复量表（ReQoL - 20），在个体层面进行评估，并由对分配情况不知情的统计学家使用混合效应模型和意向性分析（ITT）方法进行分析。
与对照组相比，干预组参与者在6个月时的ReQoL评分有显著更大的改善（20.1，95%CI：15.8至24.4），组间差异具有统计学意义（p<0.001）。ITT分析纳入了60个住房单元的161名参与者（86名男性和72名女性），其中90人被分配到ELR组（33个单元），71人被分配到TAU组（27个单元）。两组的总体失访率均为24%，且未报告重大不良事件。
这些结果表明，ELR是一种有效的干预措施，对居住在支持性住所中的SMI患者的生活质量恢复具有临床相关影响。虽然这些结果应在瑞典系统的背景下进行解释，但它们为支持在支持性住所中开展以康复为导向和以活动为导向的干预措施的证据不断增加做出了贡献。
基于协作联盟的、响应式、以人为本、目标导向的活动训练是一种有效的以康复为导向的干预策略。虽然多层次方法必须根据具体情况进行调整，但职业治疗师的融入可能会在支持性住所中带来临床益处。
NCT05056415。
