1
|
Wang L, Norman I, Edleston V, Oyo C, Leamy M. The Effectiveness and Implementation of Psychological First Aid as a Therapeutic Intervention After Trauma: An Integrative Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:2638-2656. [PMID: 38281196 PMCID: PMC11370167 DOI: 10.1177/15248380231221492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Psychological First Aid (PFA) is known to be an initial early intervention following traumatic exposure, yet little is known about its optimal implementation and effectiveness. This review aims to examine the evidence for the effectiveness of PFA interventions and how PFA interventions have been designed, implemented, and experienced. MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, PsychINFO, Embase, Web of Science, PILOTS, and China National Knowledge Infrastructure (in Chinese) databases were searched. Twenty studies from 4,735 records were included and quality rated, followed by an integrative synthesis of quantitative and qualitative evidence. PFA intervention following trauma exposure shows a positive effect for reducing anxiety and facilitating adaptive functioning in the immediate and intermediate term, yet the evidence for reducing Post-traumatic stress disorder/depressive symptoms is less compelling. Furthermore, commonalities in the components and techniques across different PFA approaches identified tend to align with four of Hobfoll's five essential elements: safety, calm, efficacy, and connectedness (as reflected among 7/11 PFA protocols), whereas the "hope" element was less developed. These commonalities include active listening, relaxation/stabilization, problem-solving/practical assistance, and social connection/referral. Intensive techniques such as cognitive reconstruction have also been incorporated, intensifying PFA delivery. The substantial variation observed in PFA format, timing, and duration, coupled with inadequate documentation of fidelity of implementation and adaptation, further constrains the ability to inform best practices for PFA. This is concerning for lay frontline providers, vital in early trauma response, who report implementation challenges despite valuing PFA as a time-sensitive, supportive, and practical approach.
Collapse
|
2
|
Nair M, Meirmanov S. Assessing the role of sustainability competencies in enhancing psychological first aid effectiveness for disaster responders in Fiji. Front Public Health 2024; 12:1349342. [PMID: 38989113 PMCID: PMC11234834 DOI: 10.3389/fpubh.2024.1349342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/30/2024] [Indexed: 07/12/2024] Open
Abstract
Background Psychological first aid (PFA) is essential for mental health and wellbeing after traumatic events. Integrating competency-based outcomes is crucial with the increasing demand for effective psychological first-aid interventions. This study examines the correlation between sustainability competencies and PFA principles within Fiji's disaster responder's context. Method The research was guided by a theoretical framework based on a comprehensive review of sustainability competencies and PFA principles. A cross-sectional survey assessed the importance of sustainability competencies in disaster responders to deliver PFA effectively. The survey used a stratified random sampling method to get diverse PFA-trained participants (66%) and non-PFA trained (34%), aiming to understand how these competencies can impact PFA success in various disaster situations. The survey, encompassing various domains of disaster response and a diverse range of respondents age, gender, and years of experience, employed the Likert scale to assess the importance of competencies such as integrated problem-solving, strategic, systems thinking, self-awareness, normative, collaboration, anticipatory, and critical thinking. Results The study involved 49 PFA-trained participants (55% female, 45% male) and 15 non-PFA-trained participants (53% female, 46% male), excluding 10 responses from the latter group due to ambiguous answers to critical questions. The correlation between age, experience, and the valuation of professional competencies among disaster responders indicates that disaster responders, with extensive experience and PFA training, rated competencies as "important," reflecting a perspective shaped by long-term career development and practical experiences. Equally, younger and early career responders emphasize competencies as "very important," indicating an initial recognition of their significance. The appraisal patterns across different age groups, especially among those with PFA training, suggest a tendency to moderate assessments of competency importance with increasing experience. Statistical analysis, including mean, median, standard deviation, and variance, provided a detailed understanding of the data, underscoring competencies like self-awareness in both data sets and integrated problem-solving and collaboration within PFA-trained responders as the key for effective PFA interventions. Conclusion The study underlines the critical need to integrate sustainability competencies into the PFA curriculum in Fiji's unique sociocultural context. This interplay between age, experience, and competency assessment stresses the diverse factors influencing perceptions in the disaster response field beyond experience alone. The results show that sustainability competencies are the ultimate to the effectiveness of PFA measurement and interventions. The research lays the foundation for future studies to develop validated tools for assessing sustainable competencies in different cultural contexts, thereby improving the effectiveness of PFA in disaster management. Integrating these competencies into PFA training could significantly strengthen PFA intervention and competency-based evaluation.
Collapse
Affiliation(s)
- Malini Nair
- Graduate School of Asia Pacific Studies Doctoral Degree Program, Ritsumeikan Asia Pacific University, Beppu, Japan
| | - Serik Meirmanov
- College of Sustainability and Tourism, Ritsumeikan Asia Pacific University, Beppu, Japan
| |
Collapse
|
3
|
Costello Z, Roberson-Miranda K, Ho S, DePierro JM, Starkweather S, Katz CL, Sharma V, Marin DB. A Resilience Program for Hospital Security Officers During the COVID-19 Pandemic Using a Community Engagement Model. J Community Health 2023; 48:963-969. [PMID: 37728723 PMCID: PMC10623110 DOI: 10.1007/s10900-023-01282-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/21/2023]
Abstract
Security officers in health systems are subject to high levels of stress and current support interventions do not necessarily target their needs. To address this gap, a resilience center at a major urban tertiary care hospital utilized community engagement principles to adapt and implement resilience and mental health awareness workshops, which were informed by initial piloting. The program consisted of twelve short briefings in which officers were provided psychoeducation on psychological first aid and adaptive coping. The program reached 107 security officers (89.5% men, 95.2% people of color); both qualitative and quantitative feedback indicated a generally positive reception. Further efforts to support security officers are warranted given their high exposure to patient crises and under-acknowledgement as frontline workers in healthcare.
Collapse
Affiliation(s)
- Zorina Costello
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katheryn Roberson-Miranda
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Division of Psychological and Educational Services, Fordham University, New York, NY, USA.
| | - Scarlett Ho
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan M DePierro
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sydney Starkweather
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Craig L Katz
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Health System Design & Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanshdeep Sharma
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah B Marin
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Stress, Resilience, and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
4
|
Simms L, Ottman KE, Griffith JL, Knight MG, Norris L, Karakcheyeva V, Kohrt BA. Psychosocial Peer Support to Address Mental Health and Burnout of Health Care Workers Affected by COVID-19: A Qualitative Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4536. [PMID: 36901545 PMCID: PMC10002014 DOI: 10.3390/ijerph20054536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Health care workers in the U.S. are experiencing alarming rates of burnout. Furthermore, the COVID-19 pandemic has worsened this issue. Psychosocial peer-support programs that address general distress and are tailored to health care systems are needed. A Care for Caregivers (CFC) Program was developed at an American metropolitan university hospital and outpatient health care system. The CFC program trains "Peer Caregivers" and managers and has four components: the identification of colleagues in need of support; psychological first aid; linkage to resources; and the promotion of hope among colleagues experiencing demoralization. Qualitative interviews (n = 18) were conducted with Peer Caregivers and Managers participating in the initial piloting of the program. Results suggest that the CFC program shifts the organizational culture, teaches staff skills for recognizing and supporting others in distress, and supports those staff who are already providing these services informally. Findings suggest that staff distress resulted primarily from external factors and secondarily from internal organizational stressors. External stressors were exacerbated by the COVID-19 pandemic. Although the program has promise for addressing staff burnout, other organizational efforts are needed to simultaneously promote staff wellness. Ultimately, psychosocial peer support programs for health care workers are feasible and potentially impactful, but also require other systemic changes within a health care system to improve and sustain staff well-being.
Collapse
Affiliation(s)
- Lea Simms
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC 20037, USA
| | - Katherine E. Ottman
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC 20037, USA
| | - James L. Griffith
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC 20037, USA
| | - Michael G. Knight
- Medical Faculty Associates, George Washington University, Washington, DC 20037, USA
| | - Lorenzo Norris
- GW Resiliency & Well-Being Center, School of Medicine and Health Sciences, George Washington University, Washington, DC 20037, USA
| | - Viktoriya Karakcheyeva
- GW Resiliency & Well-Being Center, School of Medicine and Health Sciences, George Washington University, Washington, DC 20037, USA
| | - Brandon A. Kohrt
- Center for Global Mental Health Equity, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC 20037, USA
| |
Collapse
|
5
|
Tse E, Plakitsi K, Voulgaris S, Alexiou GA. The Role of a First Aid Training Program for Young Children: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:431. [PMID: 36979990 PMCID: PMC10047314 DOI: 10.3390/children10030431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Many first aid programs have been conducted in schools, and researchers have identified that interventions improved students' knowledge, skills, and attitude. This study examines the content, practices, and assessment of first aid interventions at primary schools and evaluates their effectiveness. METHODS A systematic review was undertaken. We searched MEDLINE and Cochrane library databases from January 1990 to December 2021 using the search terms: ''first aid'' AND ''primary school children''. School-based first aid training targeting 6 to 10 years old studies in English were eligible for inclusion. RESULTS We included 11 studies that were approached by experimental (n = 6) and by observational studies (n = 5). Researchers conducted interventions in Europe (n = 9) and America (n = 2). An essential part of the teaching was hands-on practice. Most studies included in their program cardiopulmonary resuscitation (n = 8) and basic life support (n = 7). The main findings showed that trained children have significantly better knowledge of and skills in first aid than those before or without training. Children under 11 years old were not strong enough to achieve the proper depth of chest compressions. Depth of chest compressions correlates with children's age, weight, height (n = 2), and body mass index (n = 3). Conclusions The effectiveness of resuscitative or non-resuscitative first-aid training for primary school children improved students' knowledge and skills. Subsequent research could investigate children's reactions in actual first aid conditions.
Collapse
Affiliation(s)
- Eleana Tse
- Department of Neurosurgery, School of Medicine, University of Ioannina, 45500 Ioannina, Greece
| | - Katerina Plakitsi
- Department of Early Childhood Education, School of Education, University of Ioannina, 45500 Ioannina, Greece
| | - Spyridon Voulgaris
- Department of Neurosurgery, School of Medicine, University of Ioannina, 45500 Ioannina, Greece
| | - George A. Alexiou
- Department of Neurosurgery, School of Medicine, University of Ioannina, 45500 Ioannina, Greece
| |
Collapse
|