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令人疲惫却又必不可少:强化住院创伤治疗项目参与者的亲身经历

Exhausting, but necessary: the lived experience of participants in an intensive inpatient trauma treatment program.

作者信息

Vaage-Kowalzik Veronica, Engeset Jeanette, Jakobsen Marianne, Andreassen Wenche, Evensen Julie Horgen

机构信息

Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

Private Practice, Oslo, Norway.

出版信息

Front Psychol. 2024 May 28;15:1341716. doi: 10.3389/fpsyg.2024.1341716. eCollection 2024.

Abstract

BACKGROUND

Intensive inpatient treatment programs have shown robust results in the treatment of post-traumatic stress disorder (PTSD). How patients experience this treatment program and what changes they experience as a result of the treatment have, however, only scarcely been explored through qualitative studies.

OBJECTIVE

This study aimed to explore the lived experience of participants in an intensive inpatient trauma treatment program. Our research questions were as follows: how do patients experience intensive trauma-focused treatment? How do they experience possible changes related to participating in the treatment program?

METHODS

Six patients diagnosed with PTSD with significant comorbidities, who recently participated in an intensive 2-week (4 + 4 days) inpatient trauma treatment program with prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), and therapist rotation (TR), were interviewed with a semi-structured qualitative interview. Transcripts were analyzed using a thematic analysis approach.

RESULTS

Our analysis resulted in five main themes: (1) the need to feel safe; (2) the benefits of many and different therapeutic encounters; (3) variable experience with elements of treatment; (4) intensity; and (5) experienced change. Our results suggest that feeling safe within the framework of the treatment program facilitated the treatment process. Many and different therapeutic encounters, both through TR and with ward staff, contributed to experienced change. All participants described the intensity as facilitative to trauma processing. However, most participants also describe often feeling too overwhelmed to benefit from all elements of the treatment program.

CONCLUSIONS

Our findings suggest that participants experience the overall treatment program as beneficial and contributing to experienced change. Participants described the intensity of the program as exhausting, but necessary. Most did, however, report at times of being too overwhelmed to benefit from elements of the program. Consequently, our results prompt us to question the optimal level of intensity.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT05342480. Date of registration: 2022-04-22.

摘要

背景

强化住院治疗方案在创伤后应激障碍(PTSD)的治疗中已显示出显著效果。然而,通过定性研究对患者如何体验该治疗方案以及治疗后他们经历了哪些变化进行的探索却很少。

目的

本研究旨在探索强化住院创伤治疗方案参与者的实际体验。我们的研究问题如下:患者如何体验以创伤为重点的强化治疗?他们如何体验与参与治疗方案相关的可能变化?

方法

对六名被诊断患有PTSD且伴有严重共病的患者进行了半结构化定性访谈,这些患者最近参加了为期两周(4 + 4天)的强化住院创伤治疗方案,该方案包括延长暴露(PE)、眼动脱敏再处理(EMDR)和治疗师轮换(TR)。使用主题分析方法对访谈记录进行分析。

结果

我们的分析得出了五个主要主题:(1)感到安全的需求;(2)多次不同治疗接触的益处;(3)对治疗要素的不同体验;(4)强度;(5)体验到的变化。我们的结果表明,在治疗方案框架内感到安全有助于治疗过程。通过TR以及与病房工作人员的多次不同治疗接触促成了体验到的变化。所有参与者都将强度描述为有助于创伤处理。然而,大多数参与者也表示经常感到不堪重负,无法从治疗方案的所有要素中受益。

结论

我们的研究结果表明,参与者认为整个治疗方案是有益的,并促成了体验到的变化。参与者将方案的强度描述为令人疲惫但必要。然而,大多数人确实报告有时会不堪重负,无法从方案要素中受益。因此,我们的结果促使我们质疑强度的最佳水平。

试验注册

ClinicalTrials.gov标识符:NCT05342480。注册日期:2022年4月22日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6087/11165995/7a274d47999e/fpsyg-15-1341716-g0001.jpg

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