Associate Professor, S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore.
Lecturer, School of Nursing, Fudan University, Shanghai, China.
J Nurs Scholarsh. 2021 Mar;53(2):189-197. doi: 10.1111/jnu.12613. Epub 2021 Jan 21.
Contextualization of psychological first aid (PFA) in different cultural, political, and socioeconomic contexts and in different population groups is essential. This review analyzes the efforts that have been made to contextualize PFA in different parts of the world for different disasters and emergencies.
Integrative literature review.
The major databases that were searched for related literature published until August 2019 included JBI, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), BIOSIS, ISI Web of Knowledge, Scopus, EBSCOhost, and PsycINFO. A total of 17 studies published in peer-reviewed journals were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, and the 6W3H tool was applied to synthesize the results.
PFA has been adapted to various disasters and populations in different countries and regions. The organizations that administer PFA range from community level to national level. Professional or "outside helpers" who enter disaster-affected locations include psychologists, fire fighters, social workers, and nurses. "Inside helpers," who live and work in the disaster-affected areas, include HR staff, teachers, and peer emergency personnel. Only a few studies have reported the exact number of first responders who administered PFA. Some studies revised PFA as group based, and a few reported the classification of groups of victims. Notably, all adaptations adhered to the basic principles of PFA, and the time at which PFA was administered ranged from a few days to months after an incident. PFA was conducted on site in all studies. The selection of the location depended on the type of disaster and local situation with due consideration of safety. Only a few studies specified the rationale for revising the PFA. None of these 17 studies reported the cost, cost-benefit, or cost-effectiveness of PFA.
Population-focused, context-specific, and group-based PFA is emerging worldwide. Nurses are actively playing a role in providing PFA. Research gaps exist in differentiating between the roles played by "outside" and "inside" responders, considering vulnerable age groups other than children, incorporating the major PFA concepts such as resilience, and evaluating the cost-effectiveness of PFA.
It is imperative that nurses and other emergency staff consider the intersection of age, gender, cultural, political, social economic, and spiritual contexts when developing a context appropriate PFA.
在不同的文化、政治和社会经济背景下以及不同的人群中对心理急救（PFA）进行情境化处理至关重要。本综述分析了为不同灾害和紧急情况在世界不同地区进行 PFA 情境化处理所做的努力。
综合文献回顾。
检索相关文献的主要数据库包括 JBI、MEDLINE、Embase、护理与联合健康文献累积索引（CINAHL）、BIOSIS、ISI Web of Knowledge、Scopus、EBSCOhost 和 PsycINFO，截至 2019 年 8 月已发表的同行评议期刊共纳入 17 项研究。综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）模型，并应用 6W3H 工具对结果进行综合。
PFA 已在不同国家和地区的各种灾害和人群中得到了调整。实施 PFA 的组织范围从社区层面到国家层面不等。进入受灾地区的专业或“外部援助者”包括心理学家、消防员、社会工作者和护士。“内部援助者”，即生活和工作在受灾地区的人，包括人力资源人员、教师和同行紧急救援人员。只有少数研究报告了实施 PFA 的第一响应者的确切人数。一些研究将 PFA 修订为基于小组的形式，还有一些研究报告了受害者群体的分类。值得注意的是，所有的调整都坚持了 PFA 的基本原则，并且 PFA 的实施时间从事件发生后的几天到几个月不等。所有研究均在现场进行 PFA。地点的选择取决于灾害类型和当地情况，并适当考虑了安全性。只有少数研究指定了修订 PFA 的基本原理。这 17 项研究均未报告 PFA 的成本、成本效益或成本效益。
以人群为中心、具体情境和基于小组的 PFA 正在全球范围内出现。护士在提供 PFA 方面发挥着积极作用。在区分“外部”和“内部”响应者的角色、考虑除儿童以外的弱势群体、纳入韧性等主要 PFA 概念以及评估 PFA 的成本效益方面存在研究差距。
护士和其他应急人员在制定适合情境的 PFA 时，必须考虑年龄、性别、文化、政治、社会经济和精神背景的交叉点。
