2019年冠状病毒病大流行期间影响医院护士和医生实施创伤后应激障碍症状干预措施的因素:一项范围综述
Factors influencing the implementation of interventions for symptoms of posttraumatic stress disorder among hospital-based nurses and physicians during the COVID-19 pandemic: a scoping review.
作者信息
Katzmarzyk Deliah, Holle Daniela, Roes Martina
机构信息
Faculty of Health, School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, Witten, 58455, Germany.
Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Carl-Neuberg-Straße 1, Hannover, 30625, Germany.
出版信息
BMC Health Serv Res. 2025 Jul 2;25(1):885. doi: 10.1186/s12913-025-13005-z.
BACKGROUND
In the field of posttraumatic stress disorder (PTSD) among nurses and physicians working in an acute hospital setting, various investigations have been conducted on the prevalence of PTSD during the COVID-19 pandemic rather than on the implementation of PTSD-related interventions to improve the mental health of health care workers. It is known that implementation faces challenges, such as social restrictions or the dynamic of the pandemic itself. However, for successful implementation under these conditions, identifying barriers and facilitators is inevitable before using tailored implementation strategies. The following research question was addressed: What are the barriers/facilitators in the implementation of PTSD-related interventions for nurses and physicians working in an acute hospital setting during the COVID-19 pandemic?
METHODS
Using a scoping review approach, we conducted systematic literature searches from February to May 2023 in MEDLINE via PubMed and PsychINFO/CINAHL via EBSCO. We included primary studies (protocols), and concept articles focused on influencing factors in the implementation of PTSD-related interventions for nurses and physicians working in an acute hospital setting during the COVID-19 pandemic. We performed data analysis in MaxQDA via evaluative content analysis using the Consolidated Framework of Implementation Research (CFIR).
RESULTS
A total of 19 studies were included. Most of them used an empirical approach to evaluate the intervention during its development or adaptation process. The identified factors were mainly neutral factors that emerged from the inner setting and individuals as the intervention's target group. The management, the nurses, and the physicians as innovation recipients themselves, and the connection between the inner and outer settings could influence the implementation of PTSD-related interventions.
CONCLUSION
With these results, decision-makers in organizations in health care systems can be encouraged to implement interventions to improve PTSD among hospital-based nurses and physicians under pandemic conditions. Future research needs to focus on conducting implementation studies to evaluate influencing factors and investigate whether these factors enable or hinder the implementation of PTSD-related interventions.
背景
在急症医院工作的护士和医生的创伤后应激障碍(PTSD)领域,针对COVID-19大流行期间PTSD的患病率进行了各种调查,而不是关于实施与PTSD相关的干预措施以改善医护人员的心理健康。众所周知,实施面临挑战,例如社会限制或大流行本身的动态变化。然而,为了在这些条件下成功实施,在使用量身定制的实施策略之前,识别障碍和促进因素是不可避免的。以下研究问题得到了解决:在COVID-19大流行期间,为急症医院工作的护士和医生实施与PTSD相关的干预措施的障碍/促进因素是什么?
方法
我们采用范围综述方法,于2023年2月至5月在通过PubMed的MEDLINE以及通过EBSCO的PsychINFO/CINAHL中进行了系统的文献检索。我们纳入了主要研究(方案)以及专注于影响为在COVID-19大流行期间急症医院工作的护士和医生实施与PTSD相关干预措施的因素的概念文章。我们通过使用实施研究综合框架(CFIR)的评估性内容分析,在MaxQDA中进行了数据分析。
结果
共纳入19项研究。其中大多数在干预措施的开发或调整过程中采用实证方法来评估该干预措施。所确定的因素主要是来自内部环境和作为干预目标群体的个体的中性因素。作为创新接受者的管理人员、护士和医生本身,以及内部和外部环境之间的联系可能会影响与PTSD相关干预措施的实施。
结论
基于这些结果,可以鼓励医疗保健系统中的组织决策者在大流行条件下实施干预措施,以改善医院护士和医生的PTSD状况。未来的研究需要专注于进行实施研究,以评估影响因素,并调查这些因素是促进还是阻碍与PTSD相关干预措施的实施。