METHODS: A systematic review of electronic databases (MEDLINE, PsycINFO, CINAHL and EMBASE databases) was undertaken in June and November 2022 for studies that incorporated patient involvement in service development, and reported service-level outcomes. Included studies were synthesised into a logic model based on inputs (method of involvement), activities (changes to service) and outputs (indicators of improvement). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed when conducting this review.
RESULTS: From 10,901 records identified, nine studies were included, of which six were judged to have used co-production or co-design approaches. Included studies described service user involvement ranging from consultation to co-production. We identified a range of outputs associated with service user involvement in service planning and delivery, and reported these in the form of a logic model. These service-level outputs included improved treatment accessibility, increased referrals and greater service user satisfaction. Longer-term outcomes were rarely reported and hence it was difficult to establish whether outputs are sustained.
CONCLUSIONS: More extensive forms of involvement, namely, co-design and co-production, were associated with more positive and substantial outputs in regard to service effectiveness than more limited involvement methods. However, lived experience contributions highlighted service perception outputs may be valued more highly by service users than professionals and therefore should be considered equally important when evaluating service user involvement. Although evidence of longer term outcomes was scarce, meaningful involvement of service users in service planning and delivery appeared to improve the quality of mental health services.
UNASSIGNED: Members of a lived experience advisory panel contributed to the review findings, which were co-authored by a peer researcher. Review findings were also presented to stakeholders including service users and mental health professionals.
方法:对电子数据库的系统评价(MEDLINE,PsycINFO,CINAHL和EMBASE数据库)于2022年6月和11月进行,用于将患者参与服务开发的研究,并报告了服务水平的结果。纳入的研究被综合为基于输入的逻辑模型(参与方法),活动(服务变化)和产出(改进指标)。进行本综述时遵循PRISMA(系统评价和荟萃分析的首选报告项目)指南。
结果:从确定的10,901条记录中,包括九项研究,其中6人被判定使用了联合制作或联合设计方法。包括的研究描述了从咨询到联合制作的服务用户参与。我们确定了一系列与服务用户参与服务计划和交付相关的输出,并以逻辑模型的形式报告了这些。这些服务级别的产出包括改善治疗的可及性,增加推荐和更高的服务用户满意度。较长期的结果很少报告,因此很难确定产出是否持续。
结论:更广泛的参与形式,即,共同设计和共同制作,与更有限的参与方法相比,在服务有效性方面与更积极和实质性的产出相关。然而,强调服务感知输出的生活经验贡献可能比专业人员更重视服务用户,因此在评估服务用户参与时应被视为同等重要。虽然长期结果的证据很少,服务使用者有意义地参与服务计划和提供似乎可以提高精神卫生服务的质量。
■生活体验咨询小组的成员为审查结果做出了贡献,由同行研究人员共同撰写。审查结果还提交给利益相关者,包括服务用户和心理健康专业人员。