Nikopaschos Faye, Burrell Gail, Clark Jordan, Salgueiro Ana
Harrow Mental Health, Central and North West London NHS Foundation Trust (CNWL), London, United Kingdom.
Front Psychol. 2023 Jun 8;14:1145100. doi: 10.3389/fpsyg.2023.1145100. eCollection 2023.
The aim of this evaluation was to assess the impact of introducing a model of Trauma-Informed Care (TIC), comprising weekly Power Threat Meaning Framework (PTMF) Team Formulation and weekly Psychological Stabilisation staff training, to a National Health Service (NHS) adult acute inpatient mental health unit over a four-year period.
A retrospective service evaluation design was employed to assess for differences in the number of incidents of self-harm, seclusion and restraint in the four-year period following the introduction of TIC, when compared to the year prior.
Significant reductions were demonstrated in the monthly number of incidents of self-harm ( < 0.01; r = 0.42), seclusion ( < 0.05; r = 0.30) and restraint ( < 0.05; d = 0.55) following the introduction of TIC.
Findings suggest that PTMF Team Formulation and Psychological Stabilisation training can contribute to significant reductions in self-harm and restrictive interventions (seclusion and restraint) on adult mental health wards. Qualitative interviews with staff and service users from the unit will support a better understanding of the mechanisms of this change. Further research, employing a randomised control trial design, could increase the validity and generalisability of findings. However, the ethical implications of withholding potentially beneficial practices from a control group would need to be considered.
本评估旨在评估在四年时间里，将一种创伤知情护理（TIC）模式引入国民保健服务（NHS）成人急性住院精神科病房的影响，该模式包括每周的权力威胁意义框架（PTMF）团队制定和每周的心理稳定工作人员培训。
采用回顾性服务评估设计，以评估引入TIC后的四年期间与前一年相比，自残、隔离和约束事件数量的差异。
引入TIC后，每月自残事件数量（<0.01；r = 0.42）、隔离事件数量（<0.05；r = 0.30）和约束事件数量（<0.05；d = 0.55）均显著减少。
研究结果表明，PTMF团队制定和心理稳定培训有助于显著减少成人精神科病房的自残和限制性干预措施（隔离和约束）。对该病房的工作人员和服务使用者进行定性访谈将有助于更好地理解这种变化的机制。采用随机对照试验设计的进一步研究可以提高研究结果的有效性和普遍性。然而，需要考虑对对照组隐瞒潜在有益做法的伦理影响。
