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专业人士对道德伤害相关心理关怀方法的看法:一项定性研究。

Professionals' perspectives on relevant approaches to psychological care in moral injury: A qualitative study.

机构信息

Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK.

Department of Psychological Medicine, King's Centre for Military Health Research, King's College London, London, UK.

出版信息

J Clin Psychol. 2023 Oct;79(10):2404-2421. doi: 10.1002/jclp.23556. Epub 2023 Jun 13.

Abstract

OBJECTIVES

Despite the increasing consensus that moral injury (MI) is a unique type of psychological stressor, there is an ongoing debate about best practices for psychological care. This qualitative study explored the perceptions of UK and US professionals in the field of MI investigating advances and challenges in treatment or support delivery and issues relating to treatment/support feasibility and acceptability.

METHODS

15 professionals were recruited. Semi-structured, telephone/online interviews were carried out, and transcripts were analyzed using thematic analysis.

RESULTS

Two interconnected themes emerged: perceived barriers to appropriate care for MI cases and recommendations for providing effective care to MI patients. Professionals highlighted the challenges that occur due to the lack of empirical experience with MI, the negligence of patients' unique individual needs and the inflexibility in existing manualised treatments.

CONCLUSIONS

These findings illustrate the need to evaluate the effectiveness of current approaches and explore alternative pathways, which will effectively support MI patients in the long-term. Key recommendations include the use of therapeutic techniques which lead to a personalised and flexible support plan to meet patients' needs, increase self-compassion and encourage patients to reconnect with their social networks. Interdisciplinary collaborations (e.g., religious/spiritual figures), could be a valuable addition following patients' agreement.

摘要

目的

尽管越来越多的人认为道德伤害(MI)是一种独特的心理应激源,但关于心理护理的最佳实践仍存在争议。本定性研究探讨了英国和美国 MI 领域专业人员的看法,调查了治疗或支持提供方面的进展和挑战,以及与治疗/支持可行性和可接受性相关的问题。

方法

招募了 15 名专业人员。通过电话/在线访谈进行半结构化访谈,并使用主题分析对转录本进行分析。

结果

出现了两个相互关联的主题:MI 病例适当护理的公认障碍和为 MI 患者提供有效护理的建议。专业人员强调了由于缺乏 MI 的经验证据、忽视患者独特的个体需求以及现有手册化治疗方法缺乏灵活性而导致的挑战。

结论

这些发现说明了需要评估当前方法的有效性,并探索替代途径,这将长期有效地支持 MI 患者。主要建议包括使用治疗技术,制定个性化和灵活的支持计划,以满足患者的需求,提高自我同情,鼓励患者重新与社交网络联系。在征得患者同意后,跨学科合作(如宗教/精神领袖)可能是一个有价值的补充。

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