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PubMed1999

The psychological impact of working in emergencies and the role of debriefing.

It has been suggested that there are three major disasters each week world-wide of such a magnitude that local services are overwhelmed. Nurses are frequently involved in assisting in emergencies. This paper reviews current work looking at the impact of working in emergency settings and overseas humanitarian aid work. There is evidence that being at a disaster site or overseas humanitarian operation can be psychologically damaging. Strategies aimed at reducing this damage, such as debriefing, are poorly evaluated but often carried out as an act of faith. This is an area that needs to be addressed as nurses will increasingly be involved in this work.

Adaptation, Psychological↗
PubMed2000

Comparison of anonymous student ballots with student debriefing for faculty evaluations.

INTRODUCTION: Yearly evaluation of academic faculty teaching is required by institutions for advancement purposes and continued employment. The method in which these evaluations are collected may influence the outcome of that evaluation. We compared the results of three different data collection methods of faculty ratings. METHODS: Diagnostic radiology residents evaluated four behaviour categories of faculty in three different ways during the 1995-96 academic year. The individual anonymous ballot was compared to two student debriefing techniques. RESULTS: Ratings in individual categories and rankings of several of the faculty changed considerably depending upon the data gathering method. Individual anonymous ballots produced a higher average rating in all four categories evaluated. The average ratings were lowest in the closed meeting group. DISCUSSION: The method in which evaluation of faculty are collected influences both the numerical value of the rating as well as the ranking of the teachers within the group. Evaluation outcomes are highly dependent upon the method of data collection.

Data Collection↗
PubMed1998

Debriefing with brief group psychotherapy in a homogenous group of non-injured victims of a terrorist attack: a prospective study.

This study describes a follow-up of 15 non-injured women, all from the same socio-economic background, who were exposed to a terrorist attack in Israel. All of the women participated in group debriefing with brief group psychotherapy, involving six meetings during the first 2 months following the event. Two days after the attack, and 2 months and 6 months after the event, the women were administered a post-traumatic stress disorder (PTSD) diagnostic scale, the Impact of Event Scale (IES) and the SCL-90. At 6 months, four subjects (27%) were diagnosed with full PTSD. The IES showed significantly higher scores at the first measure than at the other two measures. Furthermore, the phobic anxiety subscale score immediately after the event was significantly associated with the General Severity Index of the SCL-90 and the severity of PTSD symptomatology at 6 months. The present paper discusses the effectiveness of psychological intervention following trauma, and raises questions concerning the need to invest public resources in this kind of intensive intervention. Suggestions are proposed regarding the desired emphasis of the psychological treatment in order to improve its benefits to victims.

Cost-Benefit Analysis↗
PubMed1995

Dealing with disasters: does psychological debriefing work?

The psychological aftermath of disaster causes significant long-term psychiatric disability and suffering to victims and rescuers alike. This paper examines the effectiveness of psychological debriefing (PD), an early intervention that is widely used and claimed to reduce long-term psychiatric morbidity in the wake of disaster. Numerous factors hamper the design of methodologically sound research in this field and there is a lack of controlled studies supporting the efficacy of PD. Further research is needed to demonstrate the effectiveness of any immediate psychological intervention before significant resources are allocated to their routine provision.

Crisis Intervention↗
PubMed2005

Alternatives to debriefing and modifications to cognitive behavior therapy for posttraumatic stress disorder.

BACKGROUND: Psychological debriefing uses brief unsystematic exposure, and is ineffective for posttraumatic stress symptoms and disorder. Systematic exposure alone and cognitive restructuring alone are each effective. Other approaches too may be useful. METHODS: The treatment of 3 posttraumatic stress disorder (PTSD) patients is detailed in which there was no exposure to the main traumatic event. There was exposure to related cues in case 1, exposure to related and other cues followed by well-being therapy (WBT) in case 2 and WBT in case 3. RESULTS: The 3 patients improved enduringly, confirming earlier findings that exposure to the main trauma is not essential for PTSD to improve. CONCLUSIONS: A study is needed of therapeutic mechanisms in PTSD and of the value of WBT in a randomized controlled trial.

Adult↗
PubMed1997

Randomised controlled trial of psychological debriefing for victims of acute burn trauma.

BACKGROUND: Psychological debriefing (PD) is widely used following major traumatic events in an attempt to reduce psychological sequelae. METHOD: One hundred and thirty-three adult burn trauma victims entered the study. After initial questionnaire completion, participants were randomly allocated to an individual/couple PD group or a control group who received no intervention; 110 (83%) were interviewed by an assessor blind to PD status three and 13 months later. RESULTS: Sixteen (26%) of the PD group had PTSD at 13-month follow-up, compared with four (9%) of the control group. The PD group had higher initial questionnaire scores and more severe dimensions of burn trauma than the control group, both of which were associated with a poorer outcome. CONCLUSION: This study seriously questions the wisdom of advocating one-off interventions post-trauma, and should stimulate research into more effective initiatives.

Adolescent↗
PubMedDate not supplied

Suicide and psychological debriefing.

The death of a patient by suicide is one of many upsetting experiences that nurses face. However, psychological debriefing after such an event is not commonly available.

Attitude of Health Personnel↗
PubMed1999

Critical incident stress debriefing (CISD) in a shipping company.

Critical incident stress debriefing (CISD) is a method used successfully to reduce suffering from stress-related ailments such as insomnia, depression, anger, headaches etc. The resources of the shipping company are very limited and, thus, networking with existing organizations and specialists is necessary to carry out CISD effectively. The present company model has been adopted to take into account various situations and levels of disaster. The model has been adopted at three levels of events:Level 1. Serious accidents on shore, sudden deaths, severe events and threats. Events involving one or only few persons. Level 2. Life-threatening occupational accidents on board ship, suicide of a workmate, sudden death and fire on board ship. Events involving one person or limited group of persons. Level 3. Disasters at sea. Severe events involving all or nearly all persons on board ship. Actions at different levels: Level 1: A leaflet describing CISD, situations where it would be appropriate and where it is available, is given to each sailor. The victim is encouraged to seek CISD from public health care centres, most of which have their own services in Finland. Level 2. Training of about 8 hours is carried out by an experienced crisis psychologist for supervisors and officers on board ship. After the training they are able to identify stressful situations. At each harbour, the shipping company has made agreements with experienced crisis psychologists to act as specialists and contact persons on shore. These nominated psychologists will initiate CISD actions when necessary. If they need extra manpower they will turn to other psychologists. Level 3. In such serious accidents, the company's own resources alone are insufficient to provide effective CISD. All available public and private resources will he needed (health care organizations, Red Cross, Church etc.).

Crisis Intervention↗
PubMed1999

The sinking of the Estonia: the effects of critical incident stress debriefing (CISD) on rescuers.

On the morning of September 28, 1994 the ferry Estonia sank off the coast of Finland. The loss of life reached 852 persons, while 137 persons were rescued. This study investigated the effectiveness of Critical Incident Stress Debriefing (CISD) as a crisis intervention process. Results of this controlled investigation revealed that the CISD intervention proved effective in reducing symptoms of distress and psychological trauma as psychometrically assessed.

Analysis of Variance↗
PubMed2001

[Debriefing of hospital professional staff after fire in a bar in Volendam].

A fire disaster in a bar on New Year's Eve 2001 in Volendam, which led to 200 victims, resulted in active participation of regional hospitals, including the academic hospital of the Free University of Amsterdam. In the first hour, more than 100 members of personnel were mobilised in this hospital. Nine doctors and nurses worked as members of medical teams at the site of the disaster; the others triaged 16 patients in the emergency room and treated 13 patients in the intensive care unit. After 4.5 hours, the influx of victims stopped and accordingly the disaster plan was deactivated. During the subsequent days, debriefings were organised on request of the hospital staff and personnel involved. These concluded that specific adjustments to hospital procedures were needed, such as a total admission stop for a few days, to prevent mental burn-out of personnel and to maintain the standard quality of care. Hospital disaster plans do not usually have specific guidelines for the emotional preparation of personnel during and immediately after a disaster, nor do they include specific guidelines for the evaluation of its emotional impact in terms of the quality of care delivered. These elements should be incorporated into every disaster plan.

Adult↗
PubMedDate not supplied

The role of trauma debriefing in occupational medicine at an airline.

Most airlines now have formally established Critical Incident Management Programs. The critical incident stress debriefing (CISD) is a tool designed to relieve and prevent event-related stress. The author focuses on the use of CISD to assist victims of smaller traumas, such as assault, bomb threats, and severe turbulence, and shares the results of an American Airlines CIS program for flight attendants.

Crisis Intervention↗
PubMedDate not supplied

Care after chaos: use of critical incident stress debriefing after traumatic workplace events.

CISD is a specific model of group debriefing, which can be used to accelerate recovery from traumatic work-place events. The impact of critical incidents may be debilitating-from recurrent intrusive images, persistent fear, displaced anger, guilt, and isolation. CISD can accomplish psychological closure, prevention, and mitigation of traumatic stress, and promote return to normalcy, benefiting the individual, organization, and the community at large. The field of critical incident stress management is open to advanced practice nurses who seek to apply their crisis-intervention expertise within a nontraditional role and workplace setting. With specialized training, the advanced practice nurse may pursue a career as a crisis-response provider, working independently or with an established CISM team. Practice requirements include CISM certification, along with the acquisition of a referral source. The prevention and mitigation of traumatic stress can yield a rewarding career in CISM.

Crisis Intervention↗
PubMed2005

Emergency response service personnel and the critical incident stress debriefing debate.

Previous research has demonstrated the potential for work-related stress associated with employment in the emergency service field. However, little research has considered effective interventions that may be used to mediate the effects of this work-related stress. Critical Incident Stress Debriefing (CISD) is one intervention that is currently employed with emergency service workers. However, the efficacy of this intervention is currently the source of much debate. The present discussion reviews the available literature regarding the effectiveness of CISD for use with emergency service workers and concludes that at this time, for this population, the call for the removal of current programs using CISD is unwarranted.

Crisis Intervention↗
PubMed1992

Debriefing victims of violence.

Public sector unions have been warning for some time about the effects of violent incidents on their members. OH clinical psychologist, Martin Bamber (right), believes that psychological debriefing can help victims of workplace violence and prevent long term problems.

Humans↗
PubMed1992

Critical incident stress debriefing in health care.

Transport team professionals have unique responsibilities and are exposed to powerful demands. They cannot avoid incidents that pose personal threats to their own emotional well being. Contact with dead or severely ill or injured children, for example, can be detrimental to the caregiver. Discussions called debriefings held after these critical incidents can decrease acute and delayed stress reactions.

Burnout, Professional↗
PubMed1994

Critical incident stress debriefings for crisis management in post-traumatic stress disorders.

Critical incident stress debriefings (CISDs) are a form of crisis management for rescuers such as police officers, fire-fighters and others involved in rescue efforts during natural disasters. This article describes a qualitative evaluation study of one police department's CISD implementation. Participant observation and semi-structured interviews were conducted with ten police officers involved in violent incidents. Results indicated that CISD was perceived as helpful by the officers in alleviating the symptoms of post-traumatic stress disorder they experienced after the violent incidents.

Adult↗