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加强对老年退伍军人的创伤知情护理:临床医生对创伤实践和课程需求的看法。

Enhancing trauma-informed care for older veterans: clinician perspectives on trauma practices and curricular needs.

作者信息

O'Malley Kelly A, Park Stella T, Tadmor Maya, Kemp Katherine, Pless Kaiser Anica, Bashian Hannah M, Baird Lola, Moye Jennifer A

机构信息

VA Boston Healthcare System, Boston, MA, USA.

Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

出版信息

Gerontol Geriatr Educ. 2024 Dec 2:1-16. doi: 10.1080/02701960.2024.2433205.

Abstract

Trauma-informed care is mandated in long-term care settings in the United States; however, little is known about clinicians' perspectives on trauma-informed care educational needs. To address this gap, we gathered responses to closed- and open-ended questions from two samples who work with older adults: (1) hospice and palliative care staff ( = 279) completing a recurring bi-annual survey, and (2) clinicians from diverse settings ( = 242) responding to live polling during a Veterans Affairs (VA) national webinar. Results of qualitative and quantitative analysis revealed that both routinely screened for trauma history or posttraumatic stress disorder (PTSD). Hospice and palliative care clinicians reported the least confidence in trauma and to trauma disclosures, while one-fifth of VA clinicians reported hesitancy to assess trauma history. Hospice and palliative staff were more confident in their knowledge of effects of trauma and applying the trauma-informed principle of "." Both groups expressed interest in additional training, specifically videos, case examples, toolkits, and attention to organizational and personal impacts of working with those with PTSD, aligning with SAMHSA recommendations. Findings identified focal areas for trauma-informed care curriculum; however, future work should fully assess current practices and gaps to inform practical, case-based, and self-efficacy focused curriculum development.

摘要

美国的长期护理机构必须提供创伤知情护理;然而,对于临床医生对创伤知情护理教育需求的看法却知之甚少。为了填补这一空白,我们收集了来自两个与老年人打交道的样本对封闭式和开放式问题的回答:(1)临终关怀和姑息治疗工作人员(n = 279),他们完成了一项每两年进行一次的定期调查;(2)来自不同机构的临床医生(n = 242),他们在退伍军人事务部(VA)的一次全国网络研讨会上对实时投票做出了回应。定性和定量分析结果显示,两组人员都会定期筛查创伤史或创伤后应激障碍(PTSD)。临终关怀和姑息治疗临床医生对创伤和创伤披露的信心最低,而五分之一的退伍军人事务部临床医生表示在评估创伤史时犹豫不决。临终关怀和姑息治疗工作人员对自己关于创伤影响的知识以及应用“……”的创伤知情原则更有信心。两组人员都表示对额外培训感兴趣,特别是视频、案例、工具包,以及关注与创伤后应激障碍患者合作对组织和个人的影响,这与药物滥用和精神健康服务管理局(SAMHSA)的建议一致。研究结果确定了创伤知情护理课程的重点领域;然而,未来的工作应该全面评估当前的实践和差距,以为注重实践、基于案例和自我效能的课程开发提供信息。

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