Recover Injury Research Center, The University of Queensland.
School of Health and Rehabilitation Sciences, The University of Queensland.
Psychol Serv. 2019 Feb;16(1):16-28. doi: 10.1037/ser0000270.
Hospitalization for illness or injury can be experienced by children and their families as traumatic, which can impede recovery and lead to ongoing problems. The provision of quality trauma-informed or psychosocial care by hospital staff may mitigate trauma-related problems; however, there is great variability in the use of psychosocial care practices. Most previous research is based on self-report data and focuses primarily on nurses and physicians. The current study aimed to investigate the use of psychosocial care practices among a range of staff in a large urban pediatric hospital, using observations and interviews. A coding matrix of practices and a set of interview questions were developed based on previous research. Participants included 18 direct care hospital staff and 10 patients. Trained observers observed 13 staff and 10 patients, and coded instances of psychosocial care; 17 staff participated in interviews. A large number of instances of psychosocial care were observed but there was substantial variability in overall use and the use of individual practices. Interviewed staff reported many benefits of psychosocial care for patients and staff, although there were some costs, including emotional fatigue. Contrary to current evidence, most staff reported they rely on visible triggers of distress or need before providing psychosocial care. Future research could investigate the optimal ratio of psychosocial to physical care practices, taking into account patient feedback and psychosocial and medical outcomes. To improve the consistency of psychosocial care, training could incorporate the practice examples documented here, include staff self-care, and encourage informal avenues of learning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
儿童及其家庭在因病或受伤住院时可能会经历创伤，这可能会阻碍康复并导致持续存在问题。医院工作人员提供优质的创伤知情或心理社会护理可能会减轻与创伤相关的问题；然而，心理社会护理实践的使用存在很大的差异。大多数先前的研究基于自我报告数据，主要关注护士和医生。本研究旨在使用观察和访谈调查一家大型城市儿科医院中一系列工作人员使用心理社会护理实践的情况。根据先前的研究，制定了实践编码矩阵和一套访谈问题。参与者包括 18 名直接护理医院工作人员和 10 名患者。经过培训的观察员观察了 13 名工作人员和 10 名患者，并对心理社会护理的实例进行了编码；17 名工作人员参加了访谈。观察到大量的心理社会护理实例，但总体使用情况和个别实践的使用情况存在很大差异。接受访谈的工作人员报告说，心理社会护理对患者和工作人员有很多好处，尽管存在一些成本，包括情绪疲劳。与当前的证据相反，大多数工作人员报告说，他们在提供心理社会护理之前，主要依靠明显的痛苦或需求触发因素。未来的研究可以调查心理社会护理与身体护理实践的最佳比例，同时考虑患者的反馈以及心理和医疗结果。为了提高心理社会护理的一致性，可以将这里记录的实践示例纳入培训中，包括工作人员的自我护理，并鼓励非正式的学习途径。（心理学信息数据库（c）2019APA，保留所有权利）。
