Peer Support Services for Individuals With Serious Mental Illnesses: Assessing the Evidence
Peer Support Services for Individuals With Serious Mental Illnesses: Assessing the Evidence
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DOI：
10.1176/appi.ps.201300244
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发表时间：
2014-04-01
影响因子：
3.8
通讯作者：
Delphin-Rittmon, Miriam E.
中科院分区：
文献类型：
--
作者：
Chinman, Matthew;George, Preethy;Delphin-Rittmon, Miriam E.
目的：本综述评估了康复期个体向患有严重精神疾病或同时发生精神和物质使用障碍的患者提供同伴支持服务的证据水平和有效性。方法：作者检索PubMed、PsycINFO、应用社会科学索引和摘要、社会学摘要、社会服务摘要、国际创伤应激文献、教育资源信息中心、护理和相关健康文献累积索引，检索1995 - 2012年同伴支持服务的结局研究。他们发现了20项研究，涉及三种服务类型：加入传统服务的同伴，担任现有临床角色的同伴，以及提供结构化课程的同伴。作者使用三个级别的证据（高、中、低）来判断研究的方法学质量。他们还描述了服务有效性的证据。结果：各类型同伴支持服务的证据水平均为中等。许多研究存在方法学上的缺陷，结果测量也各不相同。效果因服务类型而异。在方法的严谨性范围内，大多数关于两种服务类型同伴增加和同伴提供课程的研究显示了一些有利于同伴的改进。与专业人员相比，同行能够更好地减少住院病人的使用，改善一系列康复结果，尽管一项研究发现了负面影响。同伴在现有临床角色中的有效性参差不齐。结论：同伴支持服务显示了许多显著的结果。然而，更好地区分同伴角色的贡献并以更具体、一致性和严谨性进行的研究将加强证据。
Objective: This review assessed the level of evidence and effectiveness of peer support services delivered by individuals in recovery to those with serious mental illnesses or co-occurring mental and substance use disorders. Methods: Authors searched PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature for outcome studies of peer support services from 1995 through 2012. They found 20 studies across three service types: peers added to traditional services, peers in existing clinical roles, and peers delivering structured curricula. Authors judged the methodological quality of the studies using three levels of evidence (high, moderate, and low). They also described the evidence of service effectiveness. Results: The level of evidence for each type of peer support service was moderate. Many studies had methodological shortcomings, and outcome measures varied. The effectiveness varied by service type. Across the range of methodological rigor, a majority of studies of two service types peers added and peers delivering curricula showed some improvement favoring peers. Compared with professional staff, peers were better able to reduce inpatient use and improve a range of recovery outcomes, although one study found a negative impact. Effectiveness of peers in existing clinical roles was mixed. Conclusions: Peer support services have demonstrated many notable outcomes. However, studies that better differentiate the contributions of the peer role and are conducted with greater specificity, consistency, and rigor would strengthen the evidence.