Bourke Elyssia M, Douglas Ned, Nehme Ziad, Knott Jonathan, Craig Simon S, Babl Franz E
Emergency Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
J Am Coll Emerg Physicians Open. 2025 Jan 13;6(1):100030. doi: 10.1016/j.acepjo.2024.100030. eCollection 2025 Feb.
To describe the experience of health care professionals involved in the care of young people with acute severe behavioral disturbance across the acute care setting.
We used purposive and snowball sampling to recruit paramedics, nurses, doctors, and mental health clinicians caring for young people with acute severe behavioral disturbance in the prehospital and/or emergency department environments. We conducted one-to-one telephone-based semistructured qualitative interviews with each staff member. The audio recordings were transcribed verbatim, and participant pseudonyms were assigned. We iteratively developed a thematic coding structure. Data collection continued until thematic saturation was reached.
We interviewed 31 health care professionals-12 doctors, 5 nurses, 7 mental health clinicians, and 7 paramedics. Participants outlined factors they felt contributed to the young person's behavioral disturbance. They detailed the management strategies used. Participants spoke about their exposure to physical violence while managing these young people and the challenges of balancing patient and staff safety. There was a significant personal impact on participants through providing care to this cohort. Participants acknowledged the workflow, staff resource, and bystander impacts of these presentations.
Based on participant's experiences, health care staff aim to provide high-quality care to young people with behavioral disturbance in circumstances that present risks to their safety. There is variability in the way staff are currently managing these young people likely because of the limited high-quality evidence currently available, highlighting key areas for future research.
描述在急症护理环境中参与照顾急性严重行为障碍青少年的医护人员的经历。
我们采用目的抽样和滚雪球抽样的方法，招募在院前和/或急诊科环境中照顾急性严重行为障碍青少年的护理人员、护士、医生和心理健康临床医生。我们对每位工作人员进行了一对一的电话半结构式定性访谈。录音逐字转录，并为参与者分配化名。我们反复制定了一个主题编码结构。数据收集持续到达到主题饱和。
我们采访了31名医护人员，其中12名医生、5名护士、7名心理健康临床医生和7名护理人员。参与者概述了他们认为导致青少年行为障碍的因素。他们详细介绍了所采用的管理策略。参与者谈到在管理这些青少年时遭受身体暴力的情况，以及平衡患者和工作人员安全的挑战。为这一群体提供护理对参与者产生了重大的个人影响。参与者认识到这些情况对工作流程、工作人员资源和旁观者的影响。
根据参与者的经验，医护人员旨在为行为障碍青少年提供高质量护理，而这些情况会对他们的安全构成风险。目前工作人员管理这些青少年的方式存在差异，可能是因为目前高质量证据有限，这突出了未来研究的关键领域。
