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지역사회 정신건강전문요원의 외상 경험과 외상 후 지원에 대한 질적 탐색

Qualitative Exploration of Trauma Experience and Posttraumatic Support of Community Mental Health Professionals

스트레스연구 2019년 27권 4호 p.328 ~ 336
김수영 ( Kim Su-Young ) - 경기도정신건강복지센터

김희정 ( Kim Hee-Jung ) - 가천대학교 간호대학

Abstract

지역사회에서 일하는 정신건강 전문요원의 안전은 중요하며, 제도적 대응방안이 필요한 시점이다. 본연구는 전문요원 18명을 대상으로 폭력 및 외상 경험과 외상 후 지원에 대한 요구를 질적 탐색하였다.
결과로 ‘안전’, ‘스트레스’, ‘대처’, ‘지지’, ‘보호’의 5개 영역과 ‘1차 외상’, ‘2차 외상’, ‘부정적 정서’, ‘소진’, ‘업무 부담’, ‘비효과적 대응’, ‘신뢰와 공감’, ‘보호 기반 구축’, ‘역량 강화’ 의 9개 하위 범주가 도출되었다.
이를 토대로 전문요원을 위한 심리정서지원 시스템, 2인1조 개입 원칙 현실화, 응급 대응에 대한 구체적가이드라인 및 안전한 환경 제고, 기관의 인식개선 및 상급자의 슈퍼비전 능력향상, 전문요원 역량 강화를위한 교육 및 슈퍼비전 체계 강화가 필요함을 제언하였다.

Background: The study purpose was to describe experience of violence and trauma, needs for support of community mental health professionals (CMHP).

Methods: This study had a qualitative descriptive design and qualitative content analysis was used. For data collection, focus group interviews were carried out with 18 CMHP in 3 groups.

Results: Data analysis has been extracted in to 5 domains (safety, stress, coping, support, protection), 9 categories (primary trauma, secondary trauma, negative emotion, burnout, workload, ineffective response, trust and understanding, foundation for protection and empowerment) and 14 subcategories.

Conclusions: From the findings, we could know it more clearly that the community mental health field is relatively high in the risk of violence, suicide case and death of the subjects. However, the prepost- response measures for the protection of CMHP who has been violently traumatized were very insufficient. Therefore, it is necessary to prepare psychological emotional support system along with preventive and post-response measures for safety at the individual and institutional level. At the same time, it is important to create a supportive environment at the peer and organizational level. As a results we proposed that rapid preparation of the materialization of emotional support system for CMHP, mandatory application of two-person-one intervention principle, preparation of guidelines for emergency response, improvement of physical environment for safety, improvement of understanding on mental health work of institutional officials and also supervision ability of mental health senior staffs, strengthening education and supervision system for enhancement CMHP’s capacity are necessary.

키워드

지역사회; 정신건강; 외상; 지지; 질적 연구
Community; Mental health; Trauma; Support; Qualitative research
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