Heffernan Sinéad, O'Malley Maria, Curtin Margaret, Hawkins Andrew, Murphy Rachel, Goodwin John, Barry Karen, Taylor Alice, Happell Brenda, O' Donovan Áine
School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland.
Eist Linn, Child and Adolescent Mental Health Services, Cork and Kerry Healthcare, Health Service Executive, Cork, Ireland.
Int J Ment Health Nurs. 2024 Aug;33(4):978-991. doi: 10.1111/inm.13299. Epub 2024 Jan 30.
High-risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re-traumatisation of young people and deteriorating therapeutic relationships. Trauma-informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma-informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma-informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma-informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma-informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma-informed practice is crucial to recovery-focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people.
儿童和青少年住院精神科病房有时会出现高风险行为，这可能促使采取强制手段以维护安全。强制手段可能导致年轻人再次受到创伤，并使治疗关系恶化。创伤知情实践（TIP）已成功减少了强制手段的使用。虽然教育被认为是实施的基础，但对相关项目的评估仍然很少。本研究的目的是探讨心理健康专业人员对创伤知情教育项目的看法和经验，以及该项目可能对他们的实践方法产生的影响。五名心理健康专业人员同意参与，四名参与了焦点小组讨论，一名接受了个人访谈。使用布劳恩和克拉克框架对数据进行了主题分析。确定了三个主要主题。首先，转变对创伤知情实践的态度和认知。参与者认为他们对客户产生了更多的同情心，这些态度也反映在他们的临床实践中。其次，与创伤知情实践教育干预相关的挑战。人员配备问题和轮班工作使参与者难以定期参加教育课程。参与者指出了在当前临床环境中以创伤知情方式开展实践的障碍。最后，确定了跨学科沟通和支持的必要性。参与者认为所有专业人员，不仅是护士，都需要为改变实践承担责任，并且在组织层面需要更有力的支持。创伤知情实践对于以康复为重点的精神科护理实践至关重要。这些发现凸显了创伤知情实践教育的重要性，并提出了进一步改进的领域，以改善年轻人的积极心理健康结果。
