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医护人员对经典迷幻剂在重症患者临床应用中的态度和认知:一项系统综述

Health Care Workers' Attitudes Toward and Knowledge of the Clinical Application of Classic Psychedelics for People with Serious Illness: A Systematic Review.

作者信息

Barta Sam, Brooker Joanne, O'Callaghan Clare

机构信息

Faculty of Psychology, Counselling & Psychotherapy, The Cairnmillar Institute, Melbourne, Victoria, Australia.

Caritas Christi and Department of Psychosocial Cancer Care, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.

出版信息

J Palliat Med. 2025 Jun;28(6):815-828. doi: 10.1089/jpm.2024.0306. Epub 2024 Dec 4.

Abstract

Recent research indicates that psychedelic-assisted therapy (PAT) may be a safe and effective treatment for several psychiatric disorders, including those experienced by people with serious physical illness. Understanding health care workers' (HCWs') attitudes and knowledge about the clinical application of psychedelics for patients with serious illness is important in progressing research and identifying factors to consider in potential future implementation of PAT. The aim of this systematic review was to synthesize quantitative, qualitative, and mixed methods studies that explored HCWs' attitudes and knowledge about the role of psychedelics in treating psychological distress in patients with serious illness. MEDLINE, PsycInfo, and CINAHL were searched for quantitative, qualitative, or mixed methods primary empirical studies, published in English from 2006 onward. Two reviewers independently screened articles for inclusion. The Joanna Briggs Institute (JBI) convergent approach to mixed methods systematic reviews guided synthesis of the findings of included studies. One reviewer extracted data from included studies which was checked for accuracy by another reviewer. Two reviewers independently critically appraised included studies using JBI critical appraisal tools. The review included nine studies (seven qualitative, two quantitative) conducted in four countries. Five themes were developed: Polarized views about PAT for patients with serious illness; attitudes often informed by PAT research knowledge and heuristic methods; stronger evidence base needed to increase HCWs' confidence and support implementation of PAT; barriers may hinder PAT's potential integration into existing care models; and team-based approach and clinical education are essential to facilitate PAT. Although support for PAT varied, most HCWs perceived potential benefits in treating refractory distress, desired education about PAT, and called for further research to develop a stronger evidence base. Limitations of the review and included studies are discussed, along with implications of the findings and recommendations for future research.

摘要

近期研究表明,迷幻剂辅助疗法(PAT)可能是治疗多种精神疾病的一种安全有效的方法,包括患有严重躯体疾病的人所经历的精神疾病。了解医护人员(HCWs)对迷幻剂在重症患者临床应用方面的态度和知识,对于推进相关研究以及确定未来潜在实施PAT时需要考虑的因素至关重要。本系统评价的目的是综合定量、定性和混合方法研究,这些研究探讨了医护人员对迷幻剂在治疗重症患者心理困扰中作用的态度和知识。检索了MEDLINE、PsycInfo和CINAHL数据库,以查找2006年以来以英文发表的定量、定性或混合方法的原发性实证研究。两名评审员独立筛选纳入的文章。乔安娜·布里格斯研究所(JBI)混合方法系统评价的收敛方法指导了纳入研究结果的综合。一名评审员从纳入研究中提取数据,另一名评审员检查数据的准确性。两名评审员使用JBI批判性评价工具独立对纳入研究进行批判性评价。该评价纳入了在四个国家进行的九项研究(七项定性研究、两项定量研究)。形成了五个主题:对重症患者PAT的两极分化观点;态度往往受PAT研究知识和启发式方法的影响;需要更强有力的证据基础来增强医护人员对PAT的信心并支持其实施;障碍可能阻碍PAT融入现有护理模式;基于团队的方法和临床教育对于促进PAT至关重要。尽管对PAT的支持各不相同,但大多数医护人员认为在治疗难治性困扰方面有潜在益处,希望接受关于PAT的教育,并呼吁进行进一步研究以建立更有力的证据基础。讨论了该评价及纳入研究的局限性,以及研究结果的意义和对未来研究的建议。

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