Chapter 5 110 FIGURE 1. Conceptual Framework for Illness Management and Recovery (3). A recent systematic review and meta-analysis of 37 studies on self-management interventions found that these interventions reduced symptoms and the length of hospital stay, as well as enhancing functioning and quality of life. Moreover, there were statistically significant positive effects on subjective measures of recovery, self-rated recovery, and self-efficacy (7). Although this review indicated the relevance of self-management interventions, it only included nine (24%) studies on IMR. Therefore, there is a need for more IMR-specific experimental evidence. In September 2018, we conducted a literature search that yielded 65 studies on IMR, including six randomized controlled trials (RCTs) (21-28). These six RCTs yielded inconsistent results. Regarding our primary outcome—illness selfmanagement measured using the client version of the IMR scale—three RCTs reported positive results for IMR compared with the control group (22, 23, 28), while the remaining three RCTs reported null results (21, 24, 25, 27). Regarding illness management measured using the clinician version of the IMR Scale, four RCTs reported positive results for IMR (21-23, 28), while one other RCT reported null results (25, 27). Three RCTs reported that IMR had positive effects on reducing psychiatric symptoms (22, 23, 28), while the other RCTs identified in the literature search reported null results (22, 24, 26, 27). Regarding hospitalizations, only one RCT reported positive results (28); the remaining RCTs reported null results (21-24, 26). Three RCTs reported no effect on personal recovery (23-25, 27) and one other RCT reported no effect on employment (22). Two RCTs did not observe any effects of IMR (24-26). IMR program Goal setting Education about illness Using medications effectively Coping skills training Social skills training Relapse prevention training Alcohol and Drugs Use Coping Skills Meaningful Activities Social Support Program Proximal Outcomes Distal Outcomes Medications Stress Biological Vulnerability - Symptom control -Relapse Subjective recovery: - Perceived recovery - Sense of purpose - Personal agency - - - - - + + - Objective recovery: - Role funcioning - Social functioning
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