Haugen Tina, Halvorsen Joar Øveraas, Friborg Oddgeir, Schei Berit, Hagemann Cecilie Therese, Kjelsvik Marianne
Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim Norway.
Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim Norway.
Eur J Psychotraumatol. 2025 Dec;16(1):2443279. doi: 10.1080/20008066.2024.2443279. Epub 2025 Jan 7.
: Early interventions using trauma-focused cognitive behavioural therapy have the potential to alleviate post-traumatic stress symptoms in individuals who have experienced recent sexual assault. Specialized Sexual Assault Centers (SACs) in Norway offers psychosocial support, however, this support varies across SACs and its efficacy has not been researched. The Early Intervention after Rape (EIR) study is a multisite randomized controlled trial designed to assess the efficacy and effectiveness of training SAC nurses and social workers to deliver a modified version of prolonged exposure therapy shortly after rape.: This article aims to present a qualitative process evaluation of the implementation of the EIR study across three SACs in Norway, from the perspective of nurses and social workers.: We conducted semi-structured interviews with fifteen nurses and social workers, ten of whom received training in prolonged exposure therapy (mPE). We used Thematic Analysis to identify themes and subthemes.: Thematic analysis yielded four significant themes for process evaluation: (1) The quality of the new intervention modified prolonged exposure was considered satisfactory through training and supervision and delivered with good adherence to the manual, although some therapists perceived the manual as too rigid; (2) Adoption dynamics within the SACs are complex and include both enthusiasm for clinical research as well as resistance to change; (3) Narrow inclusion criteria and burden with participation for patients may limit reach and representativeness of the RCT; (4) Unintended consequences were identified, such as delayed start, conflicting advices and cross-contamination, underscoring the ongoing necessity for process evaluation alongside RCTs.: This qualitative process evaluation offers insight into real-world clinical challenges with implementing a new intervention and conducting a multisite RCT within SACs in Norway. This study may inform opportunities to advance evidence-based practices for rape survivors seeking help. ClinicalTrials.gov identifier: NCT05489133..
早期采用创伤聚焦认知行为疗法进行干预，有可能缓解近期遭受性侵犯个体的创伤后应激症状。挪威的专门性侵犯中心（SACs）提供心理社会支持，然而，这种支持在各中心之间存在差异，其效果尚未得到研究。强奸后早期干预（EIR）研究是一项多中心随机对照试验，旨在评估培训SAC护士和社会工作者在强奸后不久提供改良版延长暴露疗法的疗效和效果。本文旨在从护士和社会工作者的角度，对EIR研究在挪威三个SACs中的实施进行定性过程评估。我们对15名护士和社会工作者进行了半结构化访谈，其中10人接受了延长暴露疗法（mPE）培训。我们采用主题分析法来识别主题和子主题。主题分析得出了过程评估的四个重要主题：（1）通过培训和监督，新干预措施改良延长暴露的质量被认为是令人满意的，并且在实施过程中很好地遵循了手册，尽管一些治疗师认为手册过于死板；（2）SACs内部的采用动态很复杂，既包括对临床研究的热情，也包括对变革的抵制；（3）狭窄的纳入标准和患者参与的负担可能会限制随机对照试验的范围和代表性；（4）识别出了一些意外后果，如启动延迟、建议相互冲突和交叉污染，这突出了在进行随机对照试验的同时持续进行过程评估的必要性。这种定性过程评估为在挪威SACs中实施新干预措施和进行多中心随机对照试验的实际临床挑战提供了见解。这项研究可能为推进为寻求帮助的强奸幸存者提供循证实践的机会提供信息。ClinicalTrials.gov标识符：NCT05489133。
