Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
Akershus University Hospital, Lørenskog, Norway.
BMJ Open. 2021 Nov 5;11(11):e053670. doi: 10.1136/bmjopen-2021-053670.
Healthcare professionals working in somatic departments are not trained to recognise signs of torture or provide appropriate healthcare to torture survivors, which may result in retraumatisation during surgical treatment.
This protocol outlines a four-stage qualitative-method strategy for the development and evaluation of guidelines for prevention of retraumatisation of torture survivors during surgical care. The systematic search for literature review in stages 1 and 2 was conducted in August 2019 and March 2021, respectively, using nine databases. The search strategies employed in stage 1, without imposing any date limits, resulted in the inclusion of eight studies that addressed inadequate healthcare strategies associated with retraumatisation. The clinical guidelines review in stage 2 will include publications from 2000 onwards, which will be appraised using the Appraisal of Guidelines Research and Evaluation Version II instrument. Following multi-institutional recruitment in Norway, stage 3 will explore survivors' experiences of receiving surgical treatment using indepth interviews (n=8-12), which will be audio-recorded, transcribed verbatim and analysed using the interpretative phenomenological analysis approach. In stage 4a, based on the findings from stages 1, 2 and 3, a set of clinical guidelines for preventing retraumatisation during surgical treatment will be developed. Next, the feasibility and acceptability of the guidelines will be assessed in stage 4b in three interdisciplinary focus group interviews (n=5 per group) and text condensation analyses.
The Regional (South-East C) Committee for Medical and Health Research Ethics approved the study in May 2021 (#227624). In stages 3 and 4, an informational letter and an informed consent form will be distributed to the participants to sign before the interview. The study results will be disseminated through publications, conference presentations, and national and local public forums to healthcare professionals, service managers, policymakers and refugee-supporting agencies.
在躯体部门工作的医疗保健专业人员没有接受过识别酷刑迹象或为酷刑幸存者提供适当医疗保健的培训，这可能导致在手术治疗期间再次创伤。
本方案概述了制定和评估预防手术期间酷刑幸存者再次创伤的指南的四阶段定性方法策略。在第 1 阶段和第 2 阶段的系统文献检索分别于 2019 年 8 月和 2021 年 3 月进行，使用了九个数据库。第 1 阶段的搜索策略没有设置任何日期限制，结果包括八项研究，这些研究涉及与再次创伤相关的医疗保健策略不足。第 2 阶段的临床指南审查将包括 2000 年以后发表的出版物，这些出版物将使用评估指南研究和评价工具 II 进行评估。在挪威进行多机构招募后，第 3 阶段将使用深入访谈（n=8-12）探索幸存者接受手术治疗的经历，访谈将进行录音、逐字转录，并使用解释现象学分析方法进行分析。在第 4a 阶段，将根据第 1、2 和 3 阶段的研究结果，制定一套预防手术期间再次创伤的临床指南。接下来，在第 4b 阶段，将通过三个跨学科焦点小组访谈（每组 5 人）和文本浓缩分析评估指南的可行性和可接受性。
2021 年 5 月，区域（东南 C）医学和健康研究伦理委员会批准了该研究（编号 227624）。在第 3 阶段和第 4 阶段，将向参与者分发一份信息信和知情同意书，参与者在接受采访前签署。研究结果将通过出版物、会议演讲以及国家和地方公共论坛传播给医疗保健专业人员、服务管理人员、政策制定者和难民支持机构。
