Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.
University of Toronto, Toronto, Ontario, Canada.
J Clin Nurs. 2022 Jun;31(11-12):1477-1487. doi: 10.1111/jocn.16076. Epub 2021 Oct 11.
The aim of this study was to identify literature on evaluated workplace interventions to prevent or reduce the prevalence or impact of work-related post-traumatic stress disorder (PTSD) and PTSD symptoms among hospital nurses. A second objective was to summarise and compare the characteristics and effectiveness of these interventions.
A substantial proportion of nurses report PTSD symptoms. Previous reviews have synthesised interventions to address PTSD in military and other high-risk populations, but similar work focusing on nurses has yet to be conducted.
We conducted a scoping review with the question: What interventions have been studied to prevent or treat PTSD symptoms or PTSD among nurses working in hospitals? We followed the PRISMA Scoping Review Checklist using an unregistered protocol. We searched in twelve academic and grey literature databases (e.g. MedLine, CINAHL) with no language restrictions. We included publications reporting on interventions which were evaluated for measurable impacts on PTSD and PTSD symptoms among nursing staff working in inpatient settings from 1980 to 2019, and charted study characteristics in a spreadsheet.
From 7746 results, 63 studies moved to full-text screening, and six studies met inclusion criteria. Methodologies included three randomised controlled studies, one quasi-experimental study, one pre-post feasibility study and one descriptive correlational study. Four studies reported a significant reduction in PTSD scores in intervention groups compared with baseline or comparison, when using debriefing, guided imagery or mindfulness-based exercises.
This review identified six studies evaluating hospital-based interventions to reduce PTSD and PTSD symptoms among hospital nurses, with some positive effects reported, contributing to a preliminary evidence base on reducing workplace trauma. Larger studies can compare nurse subpopulations, and system-level interventions should expand the focus from individuals to organisations.
This review can inform nursing and hospital leaders developing evidence-based interventions for PTSD among nurses.
本研究旨在确定评估工作场所干预措施的文献，以预防或减少医院护士中与工作相关的创伤后应激障碍（PTSD）和 PTSD 症状的发生率或影响。第二个目的是总结和比较这些干预措施的特点和效果。
相当一部分护士报告有 PTSD 症状。以前的综述综合了针对军队和其他高危人群的 PTSD 干预措施，但针对护士的类似工作尚未开展。
我们进行了范围综述，问题是：为预防或治疗在医院工作的护士中出现 PTSD 症状或 PTSD，已经研究了哪些干预措施？我们遵循 PRISMA 范围综述清单，使用未注册的方案。我们在 12 个学术和灰色文献数据库（如 MedLine、CINAHL）中进行了搜索，没有语言限制。我们纳入了报告评估对住院环境中护理人员 PTSD 和 PTSD 症状有可衡量影响的干预措施的出版物，并在电子表格中记录了研究特征。
从 7746 项结果中，有 63 项研究进入全文筛选，6 项研究符合纳入标准。方法学包括 3 项随机对照研究、1 项准实验研究、1 项前后可行性研究和 1 项描述性相关性研究。4 项研究报告称，与基线或对照组相比，使用心理疏泄、引导意象或基于正念的练习时，干预组的 PTSD 评分显著降低。
本综述确定了 6 项评估医院干预措施的研究，以减少医院护士的 PTSD 和 PTSD 症状，其中一些研究报告了积极的效果，为减少工作场所创伤提供了初步的证据基础。更大规模的研究可以比较护士亚群，而系统层面的干预措施应将重点从个体扩展到组织。
本综述可以为制定针对护士 PTSD 的循证干预措施的护理和医院领导提供信息。
