Data_Sheet_3_Recovery From Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives.docx

Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised.
Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems.
Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods.
Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence.
Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention.
Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.

引言：康复理念旨在将服务使用者的视角置于服务开发与研究的核心，是一种兼顾社会需求、个人成长与社会包容的整体视角。近十年来，康复导向的研究与实践已大幅增长，但目前尚未构建出仅以有亲身经历者（lived experience）的视角为核心的综合性康复模型。
研究目的：本综述旨在开发一套康复框架，并结合具体情境阐释服务使用者与非正式照料者对严重精神健康问题康复的认知。
研究方法：本研究系统检索了6个数据库，检索式涵盖与知识、体验及叙事相关的核心术语，同时结合精神健康与个人康复主题。此外，通过灰色文献检索、参考文献追踪及专家咨询补充检索来源。数据分析采用质性元综合方法，运用持续比较法开展。
研究结果：本研究共纳入62项研究进行分析。结果显示，各研究在构建研究发现框架时所采用的康复范式呈现出一定的共性特征。最终形成的康复框架涵盖四大领域：社会康复（Social recovery）、繁荣发展（Prosperity，涵盖法律、政治与经济层面的康复）、个人康复（Individual Recovery）及临床康复体验（Clinical Recovery Experience，缩写SPICE）。服务使用者对康复的定义往往优先考量社会层面，尤其重视获得接纳与建立人际联结；而照料者则更倾向于以临床层面的康复定义，如症状缓解，作为衡量标准。两类群体均强调个人层面的康复要素，如实现自给自足与达成个人目标，这与拥有维持独立所需的经济条件紧密相关。
研究结论：本综述提出的康复模型可为该领域的后续研究提供参考模板，同时为政策制定与实践开展提供指导。当前主流的康复认知多聚焦于个体视角下的精神健康理解，而本综述则凸显了社会政治层面的重要意义。与此同时，仅有少量研究在低收入国家开展、聚焦少数群体，或纳入照料者视角。上述文献中的重要缺口有待后续研究进一步关注。
系统综述注册信息：本综述方案已在PROSPERO（CRD42017076450）注册，注册链接：https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450。