当前位置: X-MOL 学术JAMA › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Trauma-Informed Care May Ease Patient Fear, Clinician Burnout
JAMA ( IF 120.7 ) Pub Date : 2020-02-18 , DOI: 10.1001/jama.2020.0052
Bridget M. Kuehn

For many sexual assault survivors whom Anita Ravi, MD, MPH, sees as a New York City–based family physician, the prospect of even basic medical care can be frightening. Some have put off Papanicolaou tests and mammograms for years or even decades. To help them, Ravi has adopted a trauma-informed approach that works to restore patients’ trust and give them a greater sense of control over their visit. This may include asking permission before touching and suggesting alternatives to certain procedures that make them uncomfortable. For example, she may offer patients who require a throat or vaginal swab the option of doing it themselves. “It’s essential to give people the opportunity to know all the steps that are going to happen and say, ‘If that doesn’t work for you, we can try this other way,’” said Ravi. Trauma-informed care is already widely used in behavioral health, with guidance available from the US Substance Abuse and Mental Health Services Administration (SAMHSA). But it’s also increasingly being applied in other settings including primary care, obstetrics and gynecology, and emergency departments. In addition to addressing patient care, the approach recognizes that some clinical interactions can reevoke physicians’ own past traumas or transmit secondary trauma, said Andrea Garroway, PhD, a senior instructor in the departments of psychiatry and medicine at the University of Rochester School of Medicine and Dentistry in New York. These interactions can hurt physicians and patients alike. “A [clinician’s] ability to bring a trauma-informed approach to care is dependent on their own well-being,” Garroway said. “They can bring the most empathy, understanding, and compassion to these conversations if they’ve taken care of themselves emotionally.”

中文翻译:

创伤知情护理可缓解患者恐惧、临床医生倦怠

对于许多被 Anita Ravi 医学博士、公共卫生硕士视为纽约市家庭医生的性侵犯幸存者来说,即使是基本医疗保健的前景也可能令人恐惧。有些人已将巴氏试验和乳房 X 光检查推迟数年甚至数十年。为了帮助他们,Ravi 采用了一种基于创伤的方法,旨在恢复患者的信任并让他们对就诊有更大的控制感。这可能包括在接触之前征得许可,并建议某些让他们感到不舒服的程序的替代方案。例如,她可能会为需要喉咙或阴道拭子的患者提供自己进行检查的选项。“让人们有机会了解将要发生的所有步骤并说,'如果这对你不起作用,我们可以尝试另一种方式,'”拉维说。创伤知情护理已经广泛用于行为健康,美国药物滥用和心理健康服务管理局 (SAMHSA) 提供指导。但它也越来越多地应用于其他环境,包括初级保健、妇产科和急诊科。罗切斯特大学医学院精神病学和医学系高级讲师 Andrea Garroway 博士说,除了解决患者护理问题外,该方法还认识到一些临床互动可以唤起医生自己过去的创伤或传播继发性创伤和纽约的牙科。这些互动会伤害医生和患者。“[临床医生] 将创伤告知治疗方法的能力取决于他们自己的健康状况,”加罗威说。“他们可以带来最大的同理心,
更新日期:2020-02-18
down
wechat
bug