Justice Health and Forensic Mental Health Network, PO Box 150, Matraville 2036, NSW, Australia; University of Technology Sydney, School of Nursing & Midwifery, 235-253 Jones Street, Ultimo 2007, NSW, Australia.
University of Technology Sydney, School of Nursing & Midwifery, 235-253 Jones Street, Ultimo 2007, NSW, Australia.
Int J Nurs Stud. 2021 May;117:103897. doi: 10.1016/j.ijnurstu.2021.103897. Epub 2021 Feb 4.
Forensic mental health is a challenging workplace, with nurses subject to various trauma exposures in their professional role.
To identify the key concepts related to the nature, extent and impact of workplace trauma for forensic mental health nurses.
A scoping review, informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) tool.
Sources of evidence were identified and assessed for inclusion using an explicit search strategy. Relevant information was extracted and synthesised to present a descriptive summary of existing evidence.
Of the 16 articles on workplace trauma for forensic mental health nurses included in the review, nine reported data related to extent (incidence and severity) and 14 described the impact. The incidence (per bed/per year) of each workplace trauma type ranged from 0.95 - 7.15 for physical violence, 0.39-5.12 for verbal abuse, 0.03-0.12 for sexual violence, and 1.47-7.9 for self-harming behaviour. The proportion of incidents at the lowest severity rating ranged from 15.1% to 84.7%, and the range for the highest severity rating was 0% to 38.7%. In the single study that examined the incidence of vicarious trauma, 14.9% reported low levels and 27.7% reported high levels. Psychological distress was the most commonly reported impact of workplace trauma, identified in eight studies. Seven studies reported limited data for physical injury from workplace trauma. The impacts of exposure to workplace trauma reported in the remaining studies included needing to access psychological support, experiencing physiological symptoms, feeling less safe at work, and requiring time off work. With the exception of two studies providing limited data related to absenteeism, the impact for organisations was not explored in existing literature.
While studies indicated that forensic mental health nurses are frequently exposed to various forms of workplace trauma, reports of severe assaults on staff were rare. Although limited, these findings suggest that cumulative exposure to workplace trauma over time, or exposure to more severe forms of physical violence, increase forensic mental health nurse vulnerability to experiencing detrimental impacts on their personal and professional wellbeing.
法医心理健康是一个具有挑战性的工作场所，护士在其专业角色中会受到各种创伤暴露。
确定与法医心理健康护士工作场所创伤的性质、程度和影响相关的关键概念。
一项范围审查，由系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）工具提供信息。
使用明确的搜索策略确定和评估证据来源是否符合纳入标准。提取相关信息并进行综合，以呈现现有证据的描述性总结。
在审查中纳入的 16 篇关于法医心理健康护士工作场所创伤的文章中，有 9 篇报告了与程度（发生率和严重程度）相关的数据，有 14 篇描述了影响。每种工作场所创伤类型的发生率（每床位/每年）为身体暴力 0.95-7.15，言语虐待 0.39-5.12，性暴力 0.03-0.12，自伤行为 1.47-7.9。最低严重程度等级的事件比例范围为 15.1%至 84.7%，最高严重程度等级的范围为 0%至 38.7%。在唯一一项研究中，调查了替代性创伤的发生率，14.9%报告了低水平，27.7%报告了高水平。心理困扰是工作场所创伤最常报告的影响，在八项研究中得到了证实。有七项研究报告了工作场所创伤造成的身体伤害的有限数据。在其余研究中报告的接触工作场所创伤的影响包括需要获得心理支持、经历生理症状、工作时感到不安全和需要休假。除了两项研究提供了与旷工相关的有限数据外，现有文献并未探讨组织的影响。
虽然研究表明法医心理健康护士经常受到各种形式的工作场所创伤的暴露，但对工作人员严重袭击的报告却很少。尽管数据有限，但这些发现表明，随着时间的推移，工作场所创伤的累积暴露或暴露于更严重的身体暴力形式，会增加法医心理健康护士在个人和职业健康方面受到不利影响的脆弱性。
