Rees Nigel, Rapport Frances, Thomas Gareth, John Ann, Snooks Helen
Swansea University, Pre-hospital Emergency Research Unit, Welsh Ambulance Services NHS Trust, United Kingdom.
Swansea University, Pre-hospital Emergency Research Unit, Welsh Ambulance Services NHS Trust, United Kingdom.
J Psychosom Res. 2014 Dec;77(6):449-56. doi: 10.1016/j.jpsychores.2014.09.006. Epub 2014 Sep 16.
The U.K. has one of the highest rates of self harm in Europe at 400 per 100,000 of population. Paramedics and emergency staff may be the first professionals encountered, therefore understanding their views and approaches to care is crucial. The aim of this study was to systematically review published quantitative literature relating to paramedic and emergency workers' perceptions and experiences of caring for people who self harm.
CINAHL®, MEDLINE®, OVID ® and Psych INFO® databases were searched, PRISMA guidelines were followed, two researchers independently screened titles, abstracts and full papers against a priori eligibility criteria. Data synthesis was achieved by extracting and descriptively analysing study characteristics and findings.
16 studies met inclusion criteria; one included ambulance staff, all used questionnaires. Training, policies and guidelines improved staff knowledge and confidence in caring for people who self harm. Limited access to training was reported, ranging from 75% to 90% of staff lacking any. Limited departmental guidelines were also reported. Staff in acute settings exhibited increased feelings of negativity, becoming less positive closer to front line care. Recent studies report positive attitudes amongst emergency staff.
Despite guidelines indicating need for education and policies to guide staff in self harm care, there is limited evidence of this happening in practice. The lack of literature including paramedics suggests a gap in our understanding about care for self harm patients. This gap warrants greater attention in order to improve care for patients who self harm in their first point of contact.
英国是欧洲自残率最高的国家之一，每10万人中有400人自残。护理人员和急救人员可能是首批接触到自残者的专业人员，因此了解他们的护理观点和方法至关重要。本研究的目的是系统回顾已发表的定量文献，这些文献涉及护理人员和急救人员对自残者护理的看法和经历。
检索了CINAHL®、MEDLINE®、OVID®和Psych INFO®数据库，遵循PRISMA指南，两名研究人员根据事先确定的纳入标准独立筛选标题、摘要和全文。通过提取和描述性分析研究特征及结果来进行数据综合。
16项研究符合纳入标准；一项研究纳入了救护人员，所有研究均使用了问卷调查。培训、政策和指南提高了工作人员对自残者护理的知识和信心。据报告，培训机会有限，75%至90%的工作人员未接受过任何培训。部门指南也很有限。急症科室的工作人员消极情绪增加，在接近一线护理时积极性降低。最近的研究报告了急救人员的积极态度。
尽管指南表明需要教育和政策来指导工作人员进行自残护理，但在实践中这种情况发生的证据有限。缺乏包括护理人员在内的文献表明，我们对自残患者护理的理解存在差距。这一差距值得更多关注以便在首次接触时改善对自残患者的护理。
