A Cluster Randomized Trial of Adding Peer Specialists to Intensive Case Management Teams in the Veterans Health Administration
A Cluster Randomized Trial of Adding Peer Specialists to Intensive Case Management Teams in the Veterans Health Administration
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DOI：
10.1007/s11414-013-9343-1
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发表时间：
2015-01-01
影响因子：
1.9
通讯作者：
Young, Alexander S.
中科院分区：
文献类型：
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作者：
Chinman, Matthew;Oberman, Rebecca S.;Young, Alexander S.
同行专家（PS）的使用-患有严重精神疾病的人使用他们的经验来帮助其他患有严重精神疾病的人-正在增加。然而，它们对患者结局的影响尚未得到明确证明。这项在退伍军人健康管理局进行的随机对照试验比较了由三个强化病例管理团队服务的患者，每个团队部署了两个PS，为期1年，与三个没有PS的类似团队的患者（社区护理）。所有患者（PS组= 149，家庭护理= 133）有大量的精神病住院史和原发性轴1精神疾病。在PS工作的一年之前和之后，对患者的恢复、生活质量、激活（健康自我管理效能）、人际关系和症状进行了调查。PS组患者的改善程度显著高于（z = 2.00，df = 1，p = 0.05）接受激活时的精神护理的患者。无其他显著差异。PS帮助患者在治疗中变得更加积极，这可以促进康复。
Use of peer specialists (PSs)-individuals with serious mental illness who use their experiences to help others with serious mental illness-is increasing. However, their impact on patient outcomes has not been demonstrated definitively. This cluster randomized, controlled trial within the Veterans Health Administration compared patients served by three intensive case management teams that each deployed two PSs for 1 year, to the patients of three similar teams without PSs (Usual Care). All patients (PS group = 149, Usual Care = 133) had substantial psychiatric inpatient histories and a primary Axis 1 psychiatric disorder. Before and after the year PSs worked, patients were surveyed on their recovery, quality of life, activation (health self-management efficacy), interpersonal relations, and symptoms. Patients in the PS group improved significantly more (z = 2.00, df = 1, p = 0.05) than those receiving Usual Care on activation. There were no other significant differences. PSs helped patients become more active in treatment, which can promote recovery.