‘Being empathetic to my patients and ourselves’: a qualitative process evaluation of READ-Y psychological first aid training for healthcare workers working in routine care

<b>Introduction:</b> Healthcare workers (HCWs) are routinely exposed to distressing and potentially traumatic events during frontline care, yet receive limited structure training to manage such exposure. Psychological first aid (PFA) training has been widely disseminated among emergency responders and is increasingly being adapted for HCWs; however, its acceptability, implementation, and use in routine care remain underexplored. This study aimed to explore how an adapted PFA training programme was perceived, implemented, and used by HCWs in routine care, and to identify the mechanisms and contextual factors that influenced its impact.<b>Method:</b> A qualitative process evaluation was conducted alongside the delivery of the READ-Y (Rapport, Evaluation, Aid, Disposition, Yourself) PFA training programme in a Chinese tertiary hospital. Data collection included 3 months of observations of training delivery and 19 semi-structured interviews with HCW trainees, ward managers, and trainers/facilitators. Data were analysed using framework analysis.<b>Results:</b> Training was logistically feasible, consistently delivered, and characterized by high engagement in simulation and debriefing. Key fidelity elements of PFA training were maintained. Five key themes emerged: (1) positive reception of the adapted, blended-format training; (2) PFA was viewed as a pragmatic, stepwise tool for strengthening basic psychosocial support in routine care; (3) reported improvement in empathy, communication, and normalization of self-care among staff; (4) targeted skills development and peer learning as key mechanisms of reported change, fostering a shared language and support; and (5) multi-level contextual enablers (e.g. leadership endorsement, protected time) were identified and structural barriers (e.g. workload, burnout) existed that may hinder uptake.<b>Conclusion:</b> The adapted PFA training programme was perceived as feasible, relevant, and acceptable for HCWs, facilitating the integration of psychosocial support into routine care while promoting their own well-being. System-level integration and longitudinal evaluation of PFA training are recommended to assess sustained impact on patient and staff outcomes.