Stanborough Carol-Ann, Fletcher Chloe M E, Martinez Lee
Department of Rural Health, Rural & Remote Health SA, College of Medicine and Public Health, Flinders University, Renmark, South Australia, Australia.
IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
Int J Ment Health Nurs. 2025 Apr;34(2):e70027. doi: 10.1111/inm.70027.
Evidence suggests that health care workers are often uncomfortable talking with people about hearing voices, despite recommendations that voice-hearers be provided with opportunities to freely discuss their experiences. Moreover, in rural and remote Australia, workforce shortages mean that a broader range of workers, often non-specialists, are providing services for people with complex mental health presentations. Improving the skills of this non-specialist workforce is therefore an important endeavour. The Hearing Voices that are Distressing (HVD) simulation workshop was originally developed by voice-hearers and provides participants with first-hand experience of what it might be like to hear voices that are distressing. HVD simulation workshops were delivered by a mental health academic, a mental health clinician, and a person with lived experience to 62 health and social care workers in rural South Australia. Mixed methods were used to examine the impact of the workshop on participants' level of empathy for people who hear distressing voices. The revised Kiersma-Chen Empathy Scale assessed changes in empathy, and post-simulation reflective group discussions were qualitatively analysed. Statistically significant increases in empathy were reported following participation in the simulation (p's < 0.001). Participants reflected that having practical experience helped them develop deeper understanding of the impact hearing distressing voices has on a person's day-to-day life; how they may be preoccupied with their internal world; impacting their concentration and engagement with others. Results indicated that this training would be highly valuable for health and social care workers, and particularly generalist workers in rural settings where resources are stretched.
有证据表明，尽管有建议提出应让幻听患者有机会自由讨论他们的经历，但医护人员通常不太愿意与人们谈论幻听问题。此外，在澳大利亚农村和偏远地区，劳动力短缺意味着更广泛的工作人员（通常是非专科人员）正在为有复杂心理健康问题的人提供服务。因此，提高这支非专科劳动力队伍的技能是一项重要工作。“痛苦的幻听”（HVD）模拟工作坊最初是由幻听患者开发的，为参与者提供了亲身体验听到痛苦幻听可能是什么样的经历。HVD模拟工作坊由一位心理健康学者、一位心理健康临床医生和一位有实际经验的人在南澳大利亚农村地区为62名卫生和社会护理工作者举办。采用混合方法来检验该工作坊对参与者对痛苦幻听患者的同理心水平的影响。修订后的基尔斯马 - 陈同理心量表评估了同理心的变化，并对模拟后的反思小组讨论进行了定性分析。报告显示，参与模拟后，同理心有统计学上的显著提高（p值<0.001）。参与者反映，有实际体验帮助他们更深入地理解听到痛苦幻听对一个人日常生活的影响；他们可能如何专注于自己的内心世界；如何影响他们的注意力以及与他人的互动。结果表明，这种培训对卫生和社会护理工作者，特别是资源紧张的农村地区的通科工作者将非常有价值。
