Results of a Randomized Controlled Trial of Mental Illness Self-management Using Wellness Recovery Action Planning
Results of a Randomized Controlled Trial of Mental Illness Self-management Using Wellness Recovery Action Planning
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DOI：
10.1093/schbul/sbr012
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发表时间：
2012-06-01
影响因子：
6.6
通讯作者：
Boyd, Sherry
中科院分区：
文献类型：
--
作者：
Cook, Judith A.;Copeland, Mary Ellen;Boyd, Sherry
本研究的目的是通过比较同伴主导的疾病自我管理干预，即健康恢复行动计划（WRAP）与常规护理的效果。主要结局是精神症状减轻，次要结局是希望增加，生活质量（QOL）提高。从俄亥俄州6个社区的门诊社区精神卫生机构中招募了519名患有严重和持续性精神疾病的成年人，并随机分配到8周的干预组或等候名单对照组。在治疗结束和6个月随访时，使用意向-治疗混合效应随机回归分析评估结果。与对照组相比，在干预后立即和6个月的随访中，WRAP参与者报告：(1)简要症状量表总体症状严重程度和阳性症状总数随时间显著降低，(2)希望量表总分和目标导向希望子量表评估的希望随时间显著提高，(3)世界卫生组织生活质量bref环境子量表评估的生活质量随时间显著提高。这些结果表明，同伴提供的精神疾病自我管理培训减少了精神症状，增强了参与者的希望，并随着时间的推移改善了他们的生活质量。这证实了同伴主导的健康管理干预措施（如WRAP）作为一组循证康复服务的一部分的重要性。
The purpose of this study was to determine the efficacy of a peer-led illness self-management intervention called Wellness Recovery Action Planning (WRAP) by comparing it with usual care. The primary outcome was reduction of psychiatric symptoms, with secondary outcomes of increased hopefulness, and enhanced quality of life (QOL). A total of 519 adults with severe and persistent mental illness were recruited from outpatient community mental health settings in 6 Ohio communities and randomly assigned to the 8-week intervention or a wait-list control condition. Outcomes were assessed at end of treatment and at 6-month follow-up using an intent-to-treat mixed-effects random regression analysis. Compared to controls, at immediate postintervention and at 6-month follow-up, WRAP participants reported: (1) significantly greater reduction over time in Brief Symptom Inventory Global Symptom Severity and Positive Symptom Total, (2) significantly greater improvement over time in hopefulness as assessed by the Hope Scale total score and subscale for goal directed hopefulness, and (3) enhanced improvement over time in QOL as assessed by the World Health Organization Quality of Life-BREF environment subscale. These results indicate that peer-delivered mental illness self-management training reduces psychiatric symptoms, enhances participants' hopefulness, and improves their QOL over time. This confirms the importance of peer-led wellness management interventions, such as WRAP, as part of a group of evidence-based recovery-oriented services.