Boston Medical Center, Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA.
Department of Sociology & Anthropology, North Carolina State University, 10 Current Drive, Raleigh, NC, 27605, USA.
Harm Reduct J. 2024 Mar 19;21(1):66. doi: 10.1186/s12954-024-00975-2.
Post-overdose outreach programs engage overdose survivors and their families soon after an overdose event. Staff implementing these programs are routinely exposed to others' trauma, which makes them vulnerable to secondary traumatic stress (STS) and compassion fatigue. The purpose of this study was to explore experiences of STS and associated upstream and downstream risk and protective factors among program staff.
We conducted a post-hoc analysis of semi-structured interviews with post-overdose outreach program staff in Massachusetts. Transcripts were analyzed using a multi-step hybrid inductive-deductive approach to explore approaches and responses to outreach work, factors that might give rise to STS, and compassion fatigue resilience. Findings were organized according to the three main constructs within Ludick and Figley's compassion fatigue resilience model (empathy, secondary traumatic stress, and compassion fatigue resilience).
Thirty-eight interviews were conducted with staff from 11 post-overdose outreach programs in Massachusetts. Within the empathy construct, concern for others' well-being emerged as a motivator to engage in post-overdose outreach work - with staff trying to understand others' perspectives and using this connection to deliver respectful and compassionate services. Within the secondary traumatic stress construct, interviewees described regular and repeated exposure to others' trauma - made more difficult when exposures overlapped with staff members' personal social spheres. Within the compassion fatigue resilience construct, interviewees described the presence and absence of self-care practices and routines, social supports, and workplace supports. Job satisfaction and emotional detachment from work experiences also arose as potential protective factors. Interviewees reported inconsistent presence and utilization of formal support for STS and compassion fatigue within their post-overdose outreach teams.
Post-overdose outreach program staff may experience secondary traumatic stress and may develop compassion fatigue, particularly in the absence of resilience and coping strategies and support. Compassion fatigue resilience approaches for post-overdose outreach staff warrant further development and study.
中毒后干预项目在药物过量事件发生后不久就会接触到幸存者及其家属。实施这些项目的工作人员经常接触到他人的创伤，这使他们容易受到二次创伤应激（STS）和同情疲劳的影响。本研究的目的是探讨项目工作人员的 STS 及其相关的上游和下游风险和保护因素的经验。
我们对马萨诸塞州中毒后干预项目工作人员的半结构化访谈进行了事后分析。使用多步骤混合归纳演绎方法分析转录本，以探讨接触工作的方法和反应、可能导致 STS 和同情疲劳恢复力的因素。研究结果根据 Ludick 和 Figley 的同情疲劳恢复力模型（同理心、二次创伤应激和同情疲劳恢复力）的三个主要结构进行组织。
在马萨诸塞州的 11 个中毒后干预项目中，对 38 名工作人员进行了访谈。在同理心结构中，对他人福祉的关注是参与中毒后干预工作的动机——工作人员试图理解他人的观点，并利用这种联系提供尊重和富有同情心的服务。在二次创伤应激结构中，受访者描述了经常和重复接触到他人的创伤——当接触与工作人员的个人社交圈子重叠时，情况会更加困难。在同情疲劳恢复力结构中，受访者描述了自我保健实践和常规、社会支持和工作场所支持的存在和缺失。工作满意度和工作经历中的情感脱离也被认为是潜在的保护因素。受访者报告说，他们的中毒后干预团队中对 STS 和同情疲劳的正式支持存在不一致，且利用程度也不一致。
中毒后干预项目工作人员可能会经历二次创伤应激，并且可能会出现同情疲劳，特别是在缺乏恢复力和应对策略以及支持的情况下。中毒后干预工作人员的同情疲劳恢复力方法值得进一步发展和研究。
