在为智力障碍者和/或发育障碍者提供的服务中应用创伤知情护理的情况如何?

Megan Levington
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引用次数: 0

摘要

为应对普遍存在的不良经历和由此造成的心理创伤,创伤知情护理(TIC)在全球各种医疗、社会和教育机构中的发展势头日益强劲。鉴于智力和/或发育障碍(IDD)患者比普通人群更有可能经历创伤性生活事件,因此在为 IDD 患者提供支持的服务中引入创伤知情护理是合情合理的。然而,探索如何将创伤信息与社区整合到此类机构中的实证研究却十分匮乏,现有的有限文献也是五花八门。因此,本文旨在对新出现的文献进行梳理和归纳,以阐明在 IDD 背景下有关 TIC 的已知信息。本文采用 Arksey & O'Malley (2005) 指南进行了范围界定审查。我们使用相关检索词对 PsycINFO、Web of Science 和 PubMed 三个数据库进行了检索,共检索到自 2000 年以来发表的 69 篇论文,并对这些论文进行了系统的资格筛选。23篇论文包括各种来源类型,符合纳入标准,并进行了严格审查,采用混合方法评估工具(MMAT;Hong等人,2018年)对纳入的实证研究进行了评估。按照 PAGER 框架(Bradbury-Jones 等人,2022 年),从研究结果中得出了四种模式:(1)在 IDD 环境中嵌入 TIC 的机遇,(2)将 TIC 原则纳入特定的 IDD 服务模式,(3)在微观、中观和宏观层面实施 TIC,以及(4)在 IDD 组织中实施 TIC 的挑战和障碍。越来越多的文献探讨了如何在智障组织中实施 "技术、信息和社区",包括新出现的针对员工的 "技术、信息和社区 "培训计划。然而,仍然缺乏对服务提供者和接受者的成果进行实证实施研究。本综述讨论了临床实践的初步证据和每种发现模式的研究建议,以及本综述的优势和局限性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What is known about the application of trauma-informed care within services for people with intellectual and/or development disabilities?
Trauma-informed care (TIC) is gaining momentum in various health, social, and educational settings globally in response to the widespread pervasiveness of adverse experiences and resultant psychological trauma. Given that people with intellectual and/or developmental disabilities (IDD) are more likely to experience traumatic life events than the general population, it makes sense that TIC should be in place within services supporting individuals with IDD. Yet there is a dearth of empirical research exploring the integration of TIC in such organisations and the spread of limited available literature is diverse. Thus, this paper aimed to scope and synthesise the emerging literature to elucidate what is known -regarding TIC in the context of IDD. A scoping review was conducted using the Arksey & O’Malley (2005) guidelines. Three databases, PsycINFO, Web of Science, and PubMed, were searched using relevant search terms to retrieve 69 papers published since 2000, which were systematically screened for eligibility. Twenty-three papers comprising a range of source types met inclusion criteria and were reviewed rigorously, with included empirical studies appraised using the mixed methods appraisal tool (MMAT; Hong et al., 2018). The PAGER framework (Bradbury-Jones et al., 2022) was followed to generate four patterns from the findings: (1) Opportunities for Embedding TIC within IDD Contexts, (2) Incorporating TIC Principles into Specific IDD Service Models, (3) Implementing TIC across Micro, Meso, and Macro Levels, and (4) Challenges and Barriers to Implementing TIC in IDD Organisations. There is a growing body of literature exploring the implementation of TIC within IDD organisations, including newly emerging TIC training programmes for staff. Yet there remains a lack of empirical implementation research examining outcomes for service providers and recipients. Tentative evidence for clinical practice and research recommendations from each pattern of findings are discussed, along with strengths and limitations of this review.
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