Mental illness self-management: a randomised controlled trial of the Wellness Recovery Action Planning intervention for inpatients and outpatients with psychiatric illness
Mental illness self-management: a randomised controlled trial of the Wellness Recovery Action Planning intervention for inpatients and outpatients with psychiatric illness
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精神疾病自我管理：针对精神疾病住院患者和门诊患者的健康恢复行动计划干预的随机对照试验
DOI：
10.1017/ipm.2015.18
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发表时间：
2015
影响因子：
5.1
通讯作者：
Mary Clarke
中科院分区：
文献类型：
--
作者：
D. O’Keeffe;D. Hickey;A. Lane;M. McCormack;E. Lawlor;Anthony Kinsella;O. Donoghue;Mary Clarke
健康恢复行动计划（WRAP）是一种针对精神疾病的跨诊断、以患者为中心的自我管理干预措施。WRAP利用一个个性化的健康计划，一个由六部分组成的结构化监测和响应系统，以及一个危机和危机后计划来促进恢复。本研究的目的是评估WRAP对个人康复，生活质量和自我报告的精神症状的影响。方法采用前瞻性随机对照试验，以CONSORT原则为基础，对36例住院和门诊诊断为精神障碍的患者进行研究。参与者被随机分配到实验组或等待名单控制组条件下，1：1的比例。在三个时间点进行个人恢复、个人恢复生活领域、生活质量、焦虑和抑郁的测量：（i）干预前，（ii）实验组干预后分娩，和（iii）6个月随访。数据进行了分析，采用单变量和双变量的方法可用的情况下分析。结果WRAP对心理健康康复星星量表评定的两个个人康复生活领域有显著影响：（i）成瘾行为和（ii）自我认同和自尊。WRAP对个人康复（通过心理健康康复措施衡量），生活质量或精神症状没有显着影响。结论研究结果表明，WRAP提高个人恢复领域的（一）成瘾行为和（二）身份和自尊。需要进一步的研究来确认WRAP在其他结果领域的功效。应鼓励和评估将WRAP纳入以恢复为导向的精神卫生服务的努力。
Objective Wellness Recovery Action Planning (WRAP) is a cross-diagnostic, patient-centred, self-management intervention for psychiatric illness. WRAP utilises an individualised Wellness Toolbox, a six part structured monitoring and response system, and a crisis and post-crisis plan to promote recovery. The objective of this study was to evaluate the effect of WRAP on personal recovery, quality of life, and self-reported psychiatric symptoms. Method A prospective randomised controlled trial, based on the CONSORT principles was conducted using a sample of 36 inpatients and outpatients with a diagnosis of a mental disorder. Participants were randomly allocated to Experimental Group or Waiting List Control Group conditions in a 1:1 ratio. Measures of personal recovery, personal recovery life areas, quality of life, anxiety, and depression were administered at three time points: (i) pre-intervention, (ii) post-Experimental Group intervention delivery, and (iii) 6-month follow-up. Data was analysed by available case analysis using univariate and bivariate methodologies. Results WRAP had a significant effect on two personal recovery life areas measured by the Mental Health Recovery Star: (i) addictive behaviour and (ii) identity and self-esteem. WRAP did not have a significant effect on personal recovery (measured by the Mental Health Recovery Measure), quality of life, or psychiatric symptoms. Conclusions Findings indicate that WRAP improves personal recovery in the areas of (i) addictive behaviour and (ii) identity and self-esteem. Further research is required to confirm WRAP efficacy in other outcome domains. Efforts to integrate WRAP into recovery-orientated mental health services should be encouraged and evaluated.