Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, California, USA.
Department of Psychological Science, University of California, Irvine, California, USA.
Stress Health. 2023 Apr;39(2):347-360. doi: 10.1002/smi.3188. Epub 2022 Aug 23.
This multi-method study examined perspectives on mindfulness and coping strategies used by trauma-exposed women experiencing homelessness (WEH), residing in a state-funded residential drug treatment site in Southern California (United States). Questionnaires and in-depth focus group interviews were utilised to examine traumatic experiences over the lifespan, probable-posttraumatic stress disorder (PTSD), and coping strategies. Mindfulness was explored as a potential way to improve coping; potential benefits and challenges associated with implementing a mindfulness-based intervention (MBI) with trauma-exposed WEH were also investigated. A Community Advisory Board (CAB) was formed to identify key issues experienced by WEH and to develop a semi structured interview guide (SSIG). Using the SSIG, women participated in one of four focus groups (total N = 28; n = 7 per group). Quantitative data on demographic indicators, probable-PTSD, and trauma exposure were collected. Almost 90% of women met criteria for probable-PTSD; trauma exposure was exceedingly high; most women had experienced multiple traumas throughout their lives. Four main themes emerged from qualitative analyses, which drew from Grounded Theory and used open, selective, and axial coding: (1) ways of coping with trauma; (2) perspectives on mindfulness; (3) prior experiences with mindfulness; and (4) challenges for conducting a mindfulness programme. Overall, WEH used a variety of coping techniques to deal with their trauma, had some familiarity with mindfulness, and were optimistic an MBI would be helpful, despite identifying several challenges to implementation. MBIs may be helpful adjuncts to traditional care for trauma-exposed, WEH, recovering from substance use disorder. Population-specific considerations may improve implementation and participation.
本多方法研究探讨了经历无家可归(WEH)创伤的女性(居住在美国南加州一个州立资助的住宅药物治疗点)对正念和应对策略的看法。研究采用问卷调查和深入焦点小组访谈,考察了一生中的创伤经历、可能的创伤后应激障碍(PTSD)和应对策略。研究探讨了正念作为改善应对策略的一种潜在方法;还调查了在经历创伤的 WEH 中实施基于正念的干预(MBI)的潜在益处和挑战。成立了一个社区咨询委员会(CAB),以确定 WEH 所经历的关键问题,并制定一个半结构化访谈指南(SSIG)。使用 SSIG,女性参加了四个焦点小组之一(共 28 名参与者;每组 7 名参与者)。收集了人口统计学指标、可能的 PTSD 和创伤暴露的定量数据。近 90%的女性符合可能 PTSD 的标准;创伤暴露极高;大多数女性在一生中经历过多次创伤。从扎根理论中得出的定性分析得出了四个主要主题,并使用开放式、选择性和轴向编码:(1)应对创伤的方法;(2)对正念的看法;(3)之前对正念的体验;(4)开展正念计划的挑战。总体而言,WEH 使用各种应对技巧来应对创伤,对正念有一定的了解,并对 MBI 有帮助持乐观态度,尽管他们也确定了实施的一些挑战。MBI 可能是创伤后应激障碍的 WEH 和药物滥用康复传统治疗的有益补充。特定人群的考虑因素可能会提高实施和参与度。