Importance Although the importance of recovery-oriented care for people with severe mental illness (SMI) is widely acknowledged, essential elements such as personalization and involvement of significant others are not adequately implemented in practice. Objective To determine whether using resource groups (RGs) within flexible assertive community treatment (FACT) has favorable effects on empowerment and recovery-related outcomes in people with SMI. Design, Setting, and Participants This assessor-blind, multisite randomized clinical trial was conducted from September 1, 2017, to September 30, 2020, with follow-up at 9 and 18 months. A total of 158 participants aged 18 to 65 years meeting the criteria for SMI were randomly allocated to FACT plus RG vs FACT as usual (1:1) in 20 FACT teams throughout the Netherlands. Data were analyzed from September 1, 2020, to January 31, 2021. The study was prespecified in the trial protocol and data from the intent-to-treat population were analyzed. Interventions In the FACT plus RG condition, patients chose members from their informal and formal networks to form an RG that meets quarterly to discuss self-formulated recovery goals. The RG was integrated into the multidisciplinary support provided by the FACT team. In the FACT as-usual condition, empowerment (defined as overcoming powerlessness and gaining control of one's life) and involvement of significant others was also part of the provided care, but without the structure of the RG. Main Outcomes and Measures The primary outcome was self-reported empowerment, measured with the Netherlands Empowerment List. Results A total of 158 participants with SMI (median age, 38 [median absolute deviation, 13] years; 93 men [58.9%]) were randomized to FACT plus RG (n = 80) or FACT as usual (n = 78) care. Intention-to-treat analyses showed that randomization to the RG condition was associated with a clinically significant increase in empowerment (Cohen d, 0.54; 95% CI, 0.21-0.86) and improved outcomes with small to medium effect sizes in terms of quality of life (Cohen d, 0.25; 95% CI, -0.07 to 0.56), personal recovery (Cohen d, 0.38; 95% CI, 0.06-0.69), quality of social contact (Cohen d, 0.24; 95% CI, -0.07 to 0.56), disability (Cohen d, 0.29; 95% CI, -0.03 to 0.60), general functioning (Cohen d, 0.30; 95% CI, -0.01 to 0.62), and social functioning (Cohen d, 0.28; 95% CI, -0.04 to 0.59). No differences between conditions were found regarding psychopathological symptoms, attachment, frequency of social contact, and employment. Compared with FACT as usual, participants who stayed with the assigned treatment in the RG condition were more satisfied with treatment at 9 (Cohen d = 0.45; t135 = -2.62; P = .009) and 18 (Cohen d = 0.41; t116 = -2.22; P = .02) months. Conclusions and Relevance These findings show that working with RGs improves empowerment and other mental health outcomes in people with SMI who receive community-based mental health services. This method of network-oriented care empowers people with SMI within their own environment. Trial Registration Netherlands Trial Register Identifier: NL6548.

中文翻译：

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资源组对改善严重精神疾病患者的赋权、生活质量和功能的有效性：一项随机临床试验。

重要性 尽管对严重精神疾病 (SMI) 患者以康复为导向的护理的重要性已得到广泛认可，但在实践中并未充分实施个性化和重要他人参与等基本要素。目的 确定在灵活自信的社区治疗 (FACT) 中使用资源组 (RGs) 是否对 SMI 患者的赋权和康复相关结果产生有利影响。设计、设置和参与者这项评估者盲、多中心随机临床试验于 2017 年 9 月 1 日至 2020 年 9 月 30 日进行，随访时间分别为 9 个月和 18 个月。在荷兰各地的 20 个 FACT 团队中，共有 158 名年龄在 18 至 65 岁且符合 SMI 标准的参与者被随机分配到 FACT 加 RG 与 FACT （1:1）。分析了 2020 年 9 月 1 日至 2021 年 1 月 31 日的数据。该研究是在试验方案中预先指定的，并分析了来自意向治疗人群的数据。干预 在 FACT 加 RG 条件下，患者从他们的非正式和正式网络中选择成员，形成一个 RG，每季度开会讨论自我制定的康复目标。RG 被整合到 FACT 团队提供的多学科支持中。在 FACT 照常的情况下，授权（定义为克服无能为力并获得对自己生活的控制）和重要他人的参与也是所提供护理的一部分，但没有 RG 的结构。主要成果和措施 主要成果是自我报告的赋权，用荷兰赋权清单衡量。结果 共有 158 名 SMI 参与者（中位年龄，38 [中位绝对偏差，13] 岁；93 名男性 [58.9%]）随机接受 FACT 加 RG（n = 80）或 FACT 照常（n = 78）护理. 意向治疗分析表明，随机分配到 RG 条件与授权的临床显着增加相关（Cohen d，0.54；95% CI，0.21-0.86），并在质量方面以小到中等效应量改善结局。生活（Cohen d，0.25；95% CI，-0.07 至 0.56），个人康复（Cohen d，0.38；95% CI，0.06-0.69），社会接触质量（Cohen d，0.24；95% CI，-0.07至 0.56）、残疾（Cohen d，0.29；95% CI，-0.03 至 0.60）、一般功能（Cohen d，0.30；95% CI，-0.01 至 0.62）和社会功能（Cohen d，0.28；95% CI，-0.04 至 0.59）。在精神病理学症状、依恋、社会接触频率和就业方面，没有发现不同条件之间的差异。与通常的 FACT 相比，在 RG 条件下继续接受指定治疗的参与者在 9 岁（Cohen d = 0.45；t135 = -2.62；P = .009）和 18 岁（Cohen d = 0.41；t116 = -2.22；P = .02) 个月。结论和相关性 这些研究结果表明，与 RGs 合作可以改善接受社区精神健康服务的 SMI 患者的赋权和其他精神健康结果。这种以网络为导向的护理方法使人们能够在自己的环境中使用 SMI。试用注册荷兰试用注册标识符：NL6548。在 RG 条件下继续接受指定治疗的参与者在 9 岁（Cohen d = 0.45；t135 = -2.62；P = .009）和 18 岁（Cohen d = 0.41；t116 = -2.22；P = . 02) 月。结论和相关性 这些研究结果表明，与 RGs 合作可以改善接受社区精神健康服务的 SMI 患者的赋权和其他精神健康结果。这种以网络为导向的护理方法使人们能够在自己的环境中使用 SMI。试用注册荷兰试用注册标识符：NL6548。在 RG 条件下继续接受指定治疗的参与者在 9 岁（Cohen d = 0.45；t135 = -2.62；P = .009）和 18 岁（Cohen d = 0.41；t116 = -2.22；P = . 02) 月。结论和相关性 这些研究结果表明，与 RGs 合作可以改善接受社区精神健康服务的 SMI 患者的赋权和其他精神健康结果。这种以网络为导向的护理方法使人们能够在自己的环境中使用 SMI。试用注册荷兰试用注册标识符：NL6548。结论和相关性 这些研究结果表明，与 RGs 合作可以改善接受社区精神健康服务的 SMI 患者的赋权和其他精神健康结果。这种以网络为导向的护理方法使人们能够在自己的环境中使用 SMI。试用注册荷兰试用注册标识符：NL6548。结论和相关性 这些研究结果表明，与 RGs 合作可以改善接受社区精神健康服务的 SMI 患者的赋权和其他精神健康结果。这种以网络为导向的护理方法使人们能够在自己的环境中使用 SMI。试用注册荷兰试用注册标识符：NL6548。