文化安全的创伤知情护理青年在住宿护理:解决系统性创伤在新西兰

Jennifer Montgomery , Ema Tokolahi , Clive Aspin
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引用次数: 0

摘要

与国际标准相比,新西兰严重依赖安全的住宿护理。年轻人在住宿护理经历不成比例的高创伤率,往往表现出复杂的心理健康需求。新西兰土著人民Māori占接受国家照料的所有年轻人的一半以上,反映出长期存在的系统性不平等和殖民化的代际影响。这一实践视角考察了创伤知情护理在新西兰国家护理和保护住所以及受监督的集体之家的政策、护理模式和实践中实施的程度。采用基于社区的参与式研究方法,我们与有护理经验的青年(18-25岁)和有实践经验的关键举报人进行了接触,以告知研究。我们确定了四个主题:与身份、家庭、社区和文化的脱节;禁闭和惩罚;从断开到通过安全和持续的关系重新连接;以及护理系统需要的转型变革。几乎没有证据表明,在国家护理机构中正在实际执行创伤知情护理模式。暴露在国家护理住宅中对Māori青年造成了累积的创伤,这表明迫切需要实施一种文化上安全的创伤知情护理模式,以满足国家护理青年的需求。这项研究强调了迫切需要实施一种文化上安全的、创伤知情的护理模式,以回应国家护理中青年的复杂需求。它还确定需要采取政府和社区共同参与的办法,以改变更广泛的国家保健系统。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Culturally safe trauma-informed care for youth in residential care: Addressing systemic trauma in New Zealand
New Zealand relies heavily on secure residential care compared to international standards. Young people in residential care experience disproportionately high rates of trauma and often present with complex mental health needs. Māori, the Indigenous people of New Zealand, represent over half of all young people in State care, reflecting enduring systemic inequities and the intergenerational impacts of colonization. This practice perspective examines the extent to which trauma-informed care is implemented in policies, models of care, and practice within State care and protection residences and supervised group homes in New Zealand. Using a community-based participatory research approach, we engaged with care-experienced youth (aged 18–25 years) and practice-experienced key informants to inform the study. We identified four themes: disconnection from identity, family, community, and culture; containment and punishment within care; disconnection to reconnection through safe and continuous relationships; and the transformational changes needed in the care system. There is little evidence that a trauma-informed model of care is being implemented in practice within State care settings. Exposure to State care residences created cumulative trauma for Māori youth, demonstrating the urgent need to implement a culturally safe trauma-informed model of care to meet the needs of youth in State care.
This study highlights the urgent need to implement a culturally safe, trauma-informed model of care that responds to the complex needs of youth in State care. It also identifies the need for a whole-of-government and community approach to transform the wider State care system.
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