Appelbom Sophia, Bujacz Aleksandra, Finnes Anna, Ahlbeck Karsten, Bromberg Filip, Holmberg Johan, Larsson Liv, Olgren Birgitta, Wanecek Michael, Wetterborg Dan, Wicksell Rikard
Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden.
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Front Psychiatry. 2021 Sep 3;12:713251. doi: 10.3389/fpsyt.2021.713251. eCollection 2021.
The COVID-19 pandemic highlighted the need for psychological support initiatives directed toward frontline healthcare workers, which can be rapidly and sustainably implemented during an infectious disease outbreak. The current case study presents a comprehensive model of psychological support that was implemented at an intensive care unit (ICU) during the first wave of the COVID-19 pandemic. The psychological support model aimed at promoting a resilient stress reaction among frontline staff by protecting physical, social, and psychological resources. The initiatives, targeting different groups of workers, included education and training, peer support, psychologist-supervised and unsupervised group sessions, on-boarding for transferred staff, manager support, and individual sessions for workers experiencing strong stress reactions. The results of the process evaluation of this rapid implementation suggest that peer support initiatives as well as daily group sessions were the most appreciated forms of psychological support. Psychologists involved in organizing and providing the support highlighted several aspects of a successful implementation of the support model: offering support during work hours (preferably after shift), positive attitude of line managers that framed support initiatives as a team effort, and involvement of experienced psychologists able to quickly adjust the content of the support according to the current needs. The study also identified two main problems of the current implementation: the lack of efficient planning due to the use of volunteer work and the need for more structural resources on the organizational level to ensure long-term sustainability of the support model and its implementation among all groups of healthcare staff. The current case study highlights the importance of establishing permanent structural resources and routines for psychological support integrated in clinical practice by healthcare organizations to improve both rapid and sustainable response to future crises.
新冠疫情凸显了针对一线医护人员开展心理支持举措的必要性，这类举措应能在传染病暴发期间迅速且可持续地实施。本案例研究展示了在新冠疫情第一波期间，在一家重症监护病房（ICU）实施的全面心理支持模式。该心理支持模式旨在通过保护身体、社会和心理资源，促进一线工作人员产生适应性应激反应。针对不同群体工作人员的举措包括教育培训、同伴支持、有心理学家监督和无监督的小组会议、转岗人员入职培训、管理人员支持以及为经历强烈应激反应的工作人员提供的个别辅导。对这一快速实施过程的评估结果表明，同伴支持举措以及日常小组会议是最受认可的心理支持形式。参与组织和提供支持的心理学家强调了成功实施支持模式的几个方面：在工作时间（最好是轮班后）提供支持、直属经理持积极态度并将支持举措视为团队努力，以及经验丰富的心理学家参与其中，能够根据当前需求迅速调整支持内容。该研究还指出了当前实施过程中的两个主要问题：由于采用志愿工作导致缺乏有效规划，以及在组织层面需要更多结构性资源，以确保支持模式及其在所有医护人员群体中的实施具有长期可持续性。本案例研究强调了医疗保健组织建立融入临床实践的永久性心理支持结构性资源和常规程序的重要性，以提高对未来危机的快速和可持续应对能力。
