Central North West London NHS Foundation Trust, South Kensington and Chelsea Mental Health Centre, London, UK.
School of Social Sciences, College of Liberal Arts & Sciences, University of Westminster, London, UK.
Health Expect. 2022 Dec;25(6):3114-3123. doi: 10.1111/hex.13619. Epub 2022 Oct 1.
A person-centred model of care, developed in the early days of the HIV epidemic when there were no effective treatments for HIV, led to relatively close relationships between carers and people living with HIV (PLWH). Our study examines the experiences of carers using a relational framework, exploring the traumas and challenges involved, coping practices instigated by carers and the emergence of 'relational traumatic growth' opportunities.
Twenty-two UK healthcare workers and charity volunteers working with PLWH from the early years of the epidemic were recruited. Semistructured interviews were used to elicit participants' own stories of working with PLWH, from their initial involvement to the present time, and their reflections on the personal impact of working in the field of HIV. Data were analysed using a thematic approach employing relational categories.
The impact of care was related to the formation of close relationships, identification with PLWH, high numbers of deaths and the difficulties and challenges encountered relationally. Participants described attempts to cope through informal and formal support, as well as endeavours to manage professional boundaries. Various ways of making sense of experiences were described, ranging from denial to abandoning the HIV field, to intense commitment. For some, traumatic experiences lead to validation, a search for personal meaning and managing the sense of loss with an exploration of further ventures, contributing to the achievement of relational traumatic growth.
The intensity of relationships in HIV work, developed through the emotional and practical work of caring for PLWH, led healthcare workers and volunteers to experience a range of psychological consequences, both negative (including distress and emotional exhaustion) and also positive (such as acquiring a sense of purpose).
People living with HIV and those working with them were involved in the initial study conceptualization and design. The second and fourth authors of this paper were professionals working in HIV throughout the pandemic and have led on all aspects of the study. People living with HIV and those working with them additionally guided participant selection by suggesting participants and supporting recruitment. Narrative transcripts were checked and amended (if necessary) by participants. Initial findings were presented at the AIDS impact conference, where PLWH and those working with them attended and feedback on important ideas that helped to prioritize and shape the study findings.
在 HIV 疫情早期，当尚无有效的 HIV 治疗方法时，人们提出了一种以患者为中心的护理模式，这促成了护理人员与 HIV 感染者（PLWH）之间相对密切的关系。我们的研究使用关系框架来考察护理人员的经历，探讨其中涉及的创伤和挑战、护理人员采取的应对措施以及“关系创伤后成长”机会的出现。
招募了 22 名英国医疗保健工作者和慈善志愿者，他们在疫情早期曾与 PLWH 合作。采用半结构化访谈的方式，从参与者最初参与到现在，引出他们与 PLWH 合作的个人故事，并反思在 HIV 领域工作对个人的影响。使用主题分析方法，采用关系类别进行数据分析。
护理的影响与建立密切关系、认同 PLWH、大量死亡以及关系中遇到的困难和挑战有关。参与者描述了通过非正式和正式支持来应对的尝试，以及努力管理专业界限的情况。描述了各种理解经验的方式，从否认到放弃 HIV 领域，再到强烈的承诺。对一些人来说，创伤经历导致了验证、对个人意义的探索以及通过探索进一步的冒险来管理失落感，从而促成了关系创伤后成长的实现。
在 HIV 工作中，通过对 PLWH 的情感和实际护理工作建立的关系强度，导致医疗保健工作者和志愿者经历了一系列心理后果，既有负面的（包括痛苦和情绪疲惫），也有正面的（例如获得目标感）。
PLWH 和与他们一起工作的人参与了最初的研究概念化和设计。本文的第二和第四位作者在整个疫情期间一直从事 HIV 方面的工作，并主导了研究的各个方面。PLWH 和与他们一起工作的人还通过建议参与者和支持招募来指导参与者的选择。叙事转录本由参与者检查和修改（如果需要）。初步研究结果在艾滋病影响会议上进行了陈述，PLWH 和与他们一起工作的人参加了会议，并就有助于确定和塑造研究结果的重要观点提供了反馈。
