目的:培训不足和指南缺失会增加酷刑幸存者在外科手术期间再次遭受创伤的风险。本研究旨在制定指南以减轻这种风险,并收集医疗保健专业人员治疗酷刑幸存者的经验以及对指南的可行性和可接受性的见解。
方法:本研究分两个阶段进行。“a”阶段涉及根据对酷刑幸存者的审查制定指导方针,“在躯体护理和潜在的再创伤触发因素中遇到的情况”,以及一项关于幸存者在手术干预期间经历的定性研究。开发过程坚持建议评估的分级,开发和评估(等级)原则和评估方法学严谨的研究和评估指南(AGREEII)工具。“b”阶段涉及焦点小组和对医疗保健专业人员的个人访谈,以探索照顾酷刑幸存者的挑战并评估指南。
方法:研究,于2023年5月至8月进行,来自挪威南部和东南部三家医院的外科部门的参与者参与其中。
方法:21名医疗保健专业人员,包括外科医生,麻醉师,护士和牙医,参与研究。进行了焦点小组访谈和个人访谈。
结果:阶段\'a\':制定了包括六个部分的指南:介绍,一般指南和涵盖术前的四个部分,围手术期和术后手术阶段。b阶段:医疗保健专业人员努力了解酷刑的复杂性并确定幸存者的独特需求。他们面临挑战使用口译员和协助患者的强烈反应。虽然这些准则被认为对提高认识是实用和有用的,他们的长度受到质疑。
结论:我们为在接受手术治疗的酷刑幸存者中预防再创伤提供了建议。该指南可以作为为酷刑幸存者提供安全和个性化护理的起点。教学机构和医院可以将指南纳入医疗保健专业人员的教育。
OBJECTIVE: Insufficient training and the absence of guidelines increase the risk of retraumatisation in
torture survivors during surgical procedures. This study aims to develop guidelines to mitigate this risk and gather healthcare professionals\' experiences treating
torture survivors and insights on the
guideline\'s feasibility and acceptability.
METHODS: The study was conducted in two phases. Phase \'a\' involved developing
guidelines based on reviews of
torture survivors\' encounters in somatic care and potential retraumatisation triggers, as well as a qualitative study on survivors\' experiences during surgical interventions. The development process adhered to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument for methodological rigour. Phase \'b\' involved focus groups and individual interviews with healthcare professionals to explore challenges in caring for torture survivors and to evaluate the
guidelines.
METHODS: The study, conducted from May to August 2023, involved participants from surgical departments in three hospitals in southern and southeastern Norway.
METHODS: Twenty-one healthcare professionals, including surgeons, anaesthesiologists, nurses and a dentist, participated in the study. Both focus group interviews and individual interviews were conducted.
RESULTS: Phase \'a\': guidelines comprising six sections were developed: an introduction, general guidelines and four sections covering the preoperative, perioperative and postoperative surgical stages. Phase \'b\': healthcare professionals struggled to understand torture\'s complexities and identify survivors\' unique needs. They faced challenges using interpreters and assisting patients with strong reactions. While the guidelines were viewed as practical and useful for raising awareness, their length was questioned.
CONCLUSIONS: We provide recommendations for preventing retraumatisation in torture survivors undergoing surgical treatment. The
guidelines may serve as a starting point for offering safe and individualised care to
torture survivors. Teaching institutions and hospitals may incorporate the guidelines into healthcare professionals\' education.