Gask Linda, Dixon Clare, Morriss Richard, Appleby Louis, Green Gillian
Division of Psychiatry, University of Manchester, Manchester, UK.
J Adv Nurs. 2006 Jun;54(6):739-50. doi: 10.1111/j.1365-2648.2006.03875.x.
This paper reports a study evaluating the Skills Training On Risk Management (STORM) training initiative in three mental health services in the North-West of England, UK.
Training for health workers has been widely advocated as a key route to suicide prevention. However, reports of evaluations are scarce in the literature. In previous research, we have demonstrated that the STORM intervention results in acquisition of new skills and can be disseminated in a community setting.
The training was delivered during a 6-month period in 2002 by three mental health nurses who were seconded part-time to the project. The quantitative evaluation, which assessed change in attitudes, confidence, acquisition of skills and satisfaction, used a pretest/post-test design, with participants acting as their own controls. Qualitative interviews were conducted with a purposive sample of 16 participants to explore the impact on clinical practice, and with the three trainers at the end of the study.
Data from 458 staff members were collected during a 6-month period. Positive changes in attitudes and confidence were shown, but previous evidence of skill acquisition was not replicated. Qualitative interviews revealed important insights into changes in clinical practice, particularly for less experienced or unqualified nursing staff, but also concerns about the lack of an educational culture to foster and support such interventions in practice within the organizations.
STORM training for the assessment and management of suicide risk is both feasible and acceptable in mental health trusts. However, we remain uncertain of its longer-term impact, given the lack of engagement of senior staff in the enterprise and the absence of linked supervision and support from the organizational management to reinforce skill acquisition and development. We consider that regular supervision that links STORM training to actual clinical experience would be the ideal.
本文报告了一项对英国英格兰西北部三个心理健康服务机构的风险管理技能培训（STORM）培训计划进行评估的研究。
对卫生工作者进行培训已被广泛倡导为预防自杀的关键途径。然而，文献中关于评估报告却很稀少。在先前的研究中，我们已经证明STORM干预能够带来新技能的获得，并且可以在社区环境中推广。
2002年，由三名兼职借调到该项目的心理健康护士在6个月的时间内开展培训。定量评估通过前测/后测设计，评估态度、信心、技能获得和满意度的变化，参与者以自身作为对照。对16名有目的抽样的参与者进行定性访谈，以探讨对临床实践的影响，并在研究结束时对三名培训师进行访谈。
在6个月期间收集了458名工作人员的数据。结果显示态度和信心有积极变化，但未重现先前技能获得的证据。定性访谈揭示了对临床实践变化的重要见解，特别是对于经验较少或不合格的护理人员，但也有人担心组织内部缺乏促进和支持此类实践干预的教育文化。
在心理健康信托机构中，STORM自杀风险评估与管理培训是可行且可接受的。然而，鉴于高级工作人员未参与该项目，且缺乏组织管理层的相关监督和支持以加强技能的获得与发展，我们仍不确定其长期影响。我们认为将STORM培训与实际临床经验相联系的定期监督将是理想的做法。
