メンタルヘルスの危機チームから退院した人の同級生による自己管理:ランダム化制御試験
Sonia Johnson1, Danielle Lamb2, Louise Marston3
1Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
Lancet (London, England)
|August 14, 2018
まとめ
ピア・サポート・ワーカーによる自己管理による介入により 精神疾患患者の急性ケア再入院が 大幅に減少しました このアプローチは回復を支援し,集中的な危機管理の必要性を軽減し,サービス提供のための有望な代替案を提供します.
科学分野:
- メンタルヘルスサービス研究
- 臨床心理学
- 公衆衛生の介入
背景:
- 集中治療の高額は 回復に重点を置く精神保健サービスに 挑戦しています
- 急性精神疾患の再発は一般的です
- 自己管理の介入が急性ケア再入院に与える影響は,まだほとんど検証されていない.
研究 の 目的:
- ピア・サポート・ワーカーによって促進される自己管理の介入が急性ケア再入院率を下げるかどうかを評価する.
- 危機解決チームから退役した人のための介入の効果を評価する.
主な方法:
- イギリスの6つの危機解決チームからの参加者を対象に ランダム化制御された優位性試験が行われました
- 参加者は仲間からの支援による自己管理の介入か,またはコントロール (ポストによるワークブック) を受けました.
- 1年以内に急性ケアに再入院することが主なアウトカムでした.
主要な成果:
- 1年以内に再入院率は,対照群 (38%) よりも介入群 (29%) よりも低かった (OR 0.66,p=0. 0438).
- 比較的広い信頼区間で,入院率は予想より低かった.
- 両グループで71件の重篤な有害事象が報告されました.
結論:
- 同級生による自己管理の介入は 精神保健の急性ケア再入院を減らす可能性を示しています
- この介入の実行可能性と有効性を決定するには,さらなる評価が必要である.
- 介入の複雑さは,より広範な適用を慎重に検討することを正当化します.
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