Abstract
This assessor-blinded, multicenter randomized controlled trial aimed to examine the effectiveness of a peer-facilitated, recovery-focused self-management of Psychosis (PRSP) program supported by a psychiatric nurse (case manager) in improving recovery, mental state, problem-solving ability and other health outcomes of adults with early-stage psychosis over an 18-month follow-up (at immediately and 9 and 18 months post-intervention). The effects of the PRSP were compared with a nurse-led psychoeducation and a usual care group.
198 Chinese patients with early-stage psychosis randomly selected from 4 Community Centers for Mental Wellness (Feb-Aug 2023) and randomly assigned into 1 of the 3 study groups (PRSP, psychoeducation or usual care group) by matching with computerized random numbers. After 4-month interventions, the outcome mean scores were measured at the three post-tests and analyzed on an intention-to-treat basis using Generalised Estimating Equation test.
There were not any adverse events or harms reported/found in the study period. Significant interaction (Grp×Time) treatment effects of the PRSP were found on five outcomes (recovery, psychotic symptoms, functioning, problem-solving, and service satisfaction) between three groups over the 18-month follow-ups, Wald χ2=8.45–22.01, p=0.02-0.001, with moderate to large effect sizes (η2=0.12-0.29). Pairwise contrasts tests indicated that compared to usual care, the PRSP reported significantly greater improvements in recovery, psychotic symptoms, functioning, and service satisfaction at the 3 post-tests (p=0.01-0.005; large effects, Cohen’s d=0.8-1.2). Levels of recovery, problem-solving, and functioning of the PRSP were significantly greater improved than the psychoeducation group at the 3rd post-test (18-month) with moderate effect sizes (Cohen’s d=0.6-0.8). Intervention completion (89.4% attended ≥7 sessions), attendance (average 90.1%) and attrition (9.0%) rates in the PRSP were better than the psychoeducation group (84.8%; average 83.3%; 12.1%, accordingly).
The findings provide evidence about the sustainable effects (18 months) of the peer-facilitated illness self-management program supported by a psychiatric nurse on improving psychotic patients’ recovery, functioning, and service satisfaction. Self-management of psychosis through effective problem-solving strategies, together with nurse and co-patient supports, can be useful in early intervention service in views of inadequate healthcare resources.
Notes
References:
Chien, W.T., Chong, Y.Y., Bressington, D., & McMaster, C.W. (2024). A randomized controlled trial of an acceptance-based, insight-inducing medication adherence therapy (AIM-AT) for adults with early-stage psychosis. Psychiatry Research, 339, 116046. https://doi.org/10.1016/j.psychres.2024.116046.
Chien, W.T., Clifton, A.V., Zhao, S., and Lui, S., 2019. Peer support for people with schizophrenia or other serious mental illness. Cochrane Database of Systematic Reviews (4), CD010880. http://dx.doi.org/10.1002/14651858.CD010880.pub2.
Johnson, S., Lamb, D., Marston, L., Osborn, D., Mason, O., Henderson, C., Ambler, G., Milton, A., Davidson, M., Christoforou, M., Sullivan, S., Hunter, R., Hindle, D., Paterson, B., Leverton, M., and et al., 2018. Peer-supported self-management for people discharged from a mental health crisis team: A randomised controlled trial. The Lancet 392(10145), 409 - 418. https://doi.org/10.1016/S0140-6736(18)31470-3.
Sigma Membership
Pi Iota at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Randomized Controlled Trial
Research Approach
Quantitative Research
Keywords:
Testing Strategies, Long-term Care, Implementation Science, Psychosis, Early-stage Psychosis
Recommended Citation
Chien, Wai Tong and Gray, Richard, "Effects of a Peer-Facilitated, Recovery-Focused Illness Self-Care Program for Early-Stage Psychosis" (2025). International Nursing Research Congress (INRC). 22.
https://www.sigmarepository.org/inrc/2025/presentations_2025/22
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Effects of a Peer-Facilitated, Recovery-Focused Illness Self-Care Program for Early-Stage Psychosis
Seattle, Washington, USA
This assessor-blinded, multicenter randomized controlled trial aimed to examine the effectiveness of a peer-facilitated, recovery-focused self-management of Psychosis (PRSP) program supported by a psychiatric nurse (case manager) in improving recovery, mental state, problem-solving ability and other health outcomes of adults with early-stage psychosis over an 18-month follow-up (at immediately and 9 and 18 months post-intervention). The effects of the PRSP were compared with a nurse-led psychoeducation and a usual care group.
198 Chinese patients with early-stage psychosis randomly selected from 4 Community Centers for Mental Wellness (Feb-Aug 2023) and randomly assigned into 1 of the 3 study groups (PRSP, psychoeducation or usual care group) by matching with computerized random numbers. After 4-month interventions, the outcome mean scores were measured at the three post-tests and analyzed on an intention-to-treat basis using Generalised Estimating Equation test.
There were not any adverse events or harms reported/found in the study period. Significant interaction (Grp×Time) treatment effects of the PRSP were found on five outcomes (recovery, psychotic symptoms, functioning, problem-solving, and service satisfaction) between three groups over the 18-month follow-ups, Wald χ2=8.45–22.01, p=0.02-0.001, with moderate to large effect sizes (η2=0.12-0.29). Pairwise contrasts tests indicated that compared to usual care, the PRSP reported significantly greater improvements in recovery, psychotic symptoms, functioning, and service satisfaction at the 3 post-tests (p=0.01-0.005; large effects, Cohen’s d=0.8-1.2). Levels of recovery, problem-solving, and functioning of the PRSP were significantly greater improved than the psychoeducation group at the 3rd post-test (18-month) with moderate effect sizes (Cohen’s d=0.6-0.8). Intervention completion (89.4% attended ≥7 sessions), attendance (average 90.1%) and attrition (9.0%) rates in the PRSP were better than the psychoeducation group (84.8%; average 83.3%; 12.1%, accordingly).
The findings provide evidence about the sustainable effects (18 months) of the peer-facilitated illness self-management program supported by a psychiatric nurse on improving psychotic patients’ recovery, functioning, and service satisfaction. Self-management of psychosis through effective problem-solving strategies, together with nurse and co-patient supports, can be useful in early intervention service in views of inadequate healthcare resources.
Description
This is an assessor-blinded, multicenter RCT examining the effects of a peer-facilitated, recovery-focused self-management of Psychosis (PRSP) program supported by a psychiatric nurse at immediately and 9 and 18 months post-intervention. When compared with a psychoeducation and a usual-care-only group (n=66/group), based on ITT principle, the PRSP (n=66) reported significantly greater improvements in recovery, psychotic symptoms, functioning, and service satisfaction at the 18-month follow-up.