E-mental health self-management for psychotic disorders: state of the art and future perspectives.
E-mental health self-management for psychotic disorders: state of the art and future perspectives.
复制标题
精神障碍的电子心理健康自我管理：最新技术和未来前景。
作者：
L. van der Krieke;L. Wunderink;Ando C Emerencia;P. de Jonge;S. Sytema
目标
本次审查的目的是调查信息技术在多大程度上可以支持患有精神障碍的服务使用者的自我管理。该调查旨在回答以下问题：已经开发和评估了哪些类型的电子心理健康自我管理干预措施？目前关于已确定干预措施的临床结果和成本效益的证据是什么？电子心理健康自我管理干预措施在多大程度上面向服务使用者？
方法
对截至 2012 年 7 月来自 MEDLINE、PsycINFO、AMED、CINAHL 以及图书馆、信息科学和技术数据库的参考文献进行了系统回顾。针对精神障碍患者的电子心理健康自我管理干预措施的研究由三位评审员独立选择。
结果
28 项研究符合纳入标准。电子心理健康自我管理干预措施包括心理教育、药物管理、沟通和共同决策、日常功能管理、生活方式管理、同伴支持以及通过日常测量进行实时自我监测（经验抽样监测）。药物管理 (.92) 的总结效应值较大，心理教育 (.37) 以及沟通和共同决策 (.21) 的总结效应值较小。对于所有其他研究，计算了个体效应大小。唯一进行的经济分析报告了电子心理健康干预的短期成本更高。
结论
患有精神障碍的人能够并且愿意使用电子精神卫生服务。结果表明，电子心理健康服务至少与常规护理或非技术方法一样有效。药物管理电子心理健康服务的影响更大。没有研究报告有负面影响。必须谨慎解释结果，因为它们基于少量研究。
OBJECTIVE
The aim of this review was to investigate to what extent information technology may support self-management among service users with psychotic disorders. The investigation aimed to answer the following questions: What types of e-mental health self-management interventions have been developed and evaluated? What is the current evidence on clinical outcome and cost-effectiveness of the identified interventions? To what extent are e-mental health self-management interventions oriented toward the service user?
METHODS
A systematic review of references through July 2012 derived from MEDLINE, PsycINFO, AMED, CINAHL, and the Library, Information Science and Technology database was performed. Studies of e-mental health self-management interventions for persons with psychotic disorders were selected independently by three reviewers.
RESULTS
Twenty-eight studies met the inclusion criteria. E-mental health self-management interventions included psychoeducation, medication management, communication and shared decision making, management of daily functioning, lifestyle management, peer support, and real-time self-monitoring by daily measurements (experience sampling monitoring). Summary effect sizes were large for medication management (.92) and small for psychoeducation (.37) and communication and shared decision making (.21). For all other studies, individual effect sizes were calculated. The only economic analysis conducted reported more short-term costs for the e-mental health intervention.
CONCLUSIONS
People with psychotic disorders were able and willing to use e-mental health services. Results suggest that e-mental health services are at least as effective as usual care or nontechnological approaches. Larger effects were found for medication management e-mental health services. No studies reported a negative effect. Results must be interpreted cautiously, because they are based on a small number of studies.