PDF(Pubmed)
Abstract：
Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.
Organisations often seek to provide some form of psychosocial intervention after a traumatic event in the workplace.Previous reviews have contraindicated particular forms of ‘debriefing’, however, the evidence for post-incident psychosocial interventions in the workplace has not previously been systematically reviewed.Research evidence was generally of poor quality with limited evidence of effectiveness and clinical guidelines were inconsistent with the evidence. Nevertheless, research did not demonstrate harm from most established interventions and support was valued by workers.
Organisations often seek to provide some form of psychosocial intervention after a traumatic event in the workplace.Previous reviews have contraindicated particular forms of ‘debriefing’, however, the evidence for post-incident psychosocial interventions in the workplace has not previously been systematically reviewed.Research evidence was generally of poor quality with limited evidence of effectiveness and clinical guidelines were inconsistent with the evidence. Nevertheless, research did not demonstrate harm from most established interventions and support was valued by workers.
摘要：
背景：在工作场所发生创伤事件后，组织希望为员工提供支持，以预防PTSD。然而,什么是安全有效的还没有确定，尽管许多组织在创伤事件后提供某种形式的干预。目的：系统地审查在工作场所创伤后一个月内提供的事件后心理社会干预措施的证据，并比较内容，这些干预措施的有效性和可接受性。鉴于该领域缺乏明确的证据基础，我们试图研究已发表的实证研究以及由专家小组与高风险角色的工作人员合作发布的指南.方法：我们在书目数据库中进行了系统的实证研究搜索，并在2023年4月之前在线搜索了临床实践指南。工作场所创伤专家还提到了潜在的相关文献。对实证研究和临床指南的质量进行了评估。结果：共纳入80项研究和11项临床实践指南。干预措施包括关键事件压力汇报(CISD)，突发事件压力管理(CISM)未指定的汇报,创伤风险管理（TRIM），心理急救（PFA）EMDR,CBT和团体咨询。大多数研究和指导的质量都很差。这项审查的结果没有证明CISD造成的任何伤害，CISM,PFA,TRIM,EMDR,在工作场所提供的团体咨询或CBT干预措施。然而,他们没有最终证明这些干预措施的益处,也没有确定任何具体干预措施的优越性.一般汇报与一些负面结果有关。当前的临床指南与当前的研究证据基础不一致。然而，干预措施通常受到工人的重视。结论：迫切需要更高质量的研究和指导，包括对事件后干预措施实施的具体方面进行更详细的探讨。
在工作场所发生创伤事件后，组织常常寻求提供某种形式的心理社会干预。以前的评论有禁忌的特定形式的“汇报”，然而,之前尚未对工作场所事件后心理社会干预的证据进行系统审查.研究证据质量一般较差，有效性证据有限，临床指南与证据不一致。然而，研究未显示大多数既定干预措施的危害,支持得到了工作者的重视.
在工作场所发生创伤事件后，组织常常寻求提供某种形式的心理社会干预。以前的评论有禁忌的特定形式的“汇报”，然而,之前尚未对工作场所事件后心理社会干预的证据进行系统审查.研究证据质量一般较差，有效性证据有限，临床指南与证据不一致。然而，研究未显示大多数既定干预措施的危害,支持得到了工作者的重视.
