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“在悲痛中建立”:一群市中心家庭医生的替代性创伤。

"Building through the grief": vicarious trauma in a group of inner-city family physicians.

机构信息

South Riverdale Community Health Centre, Toronto, Ontario, Canada.

出版信息

J Am Board Fam Med. 2012 Nov-Dec;25(6):840-6. doi: 10.3122/jabfm.2012.06.120066.

Abstract

BACKGROUND

Vicarious trauma is an understudied phenomenon among Canadian family physicians.

OBJECTIVE

This phenomenological study set out to explore the experiences of a group of inner-city family physicians caring for women using illicit drugs.

METHODS

Ten family physicians working in Toronto and Ottawa, Canada, participated in in-depth interviews. The data were analyzed using an iterative and interpretive process.

RESULTS

The first major theme emerging from the data analysis was the emotional impact of the work. Participants shared the challenges, sorrows, and joys they experienced as they struggled to care for their patients. The sub-themes identified were as follows: tragedy and death, difficult behaviors, and isolation from mainstream medical community. The second major theme identified was coping strategies. Participants were open, thoughtful, and eloquent as they reflected on the three primary coping strategies reported: adaptation and evolution of practice style, teamwork, and modification of expectations.

CONCLUSIONS

Participants, narratives of loss, grief, and compassion were consistent with vicarious trauma and therefore participants risked developing compassion fatigue--a specific form of burnout. These are new and important findings. Further research exploring vicarious trauma as a possible contributor to burnout among family physicians is warranted.

摘要

背景

替代性创伤是加拿大家庭医生中一个研究不足的现象。

目的

本现象学研究旨在探讨一组照顾使用非法药物的女性的市中心家庭医生的经历。

方法

加拿大多伦多和渥太华的 10 名家庭医生参加了深入访谈。使用迭代和解释性过程对数据进行分析。

结果

数据分析中出现的第一个主要主题是工作的情感影响。参与者分享了他们在努力照顾患者时所经历的挑战、悲伤和喜悦。确定的子主题如下:悲剧和死亡、不良行为和与主流医学界隔离。确定的第二个主要主题是应对策略。参与者在反思报告的三种主要应对策略时表现出开放、深思熟虑和雄辩:实践风格的适应和演变、团队合作和期望的调整。

结论

参与者的失落、悲伤和同情的叙述与替代性创伤一致,因此参与者有患同情疲劳的风险——一种特定形式的倦怠。这些是新的和重要的发现。有必要进一步研究替代性创伤是否可能导致家庭医生倦怠。

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