Stuber Margaret L, Shemesh Eyal
Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024-1759, USA.
Child Adolesc Psychiatr Clin N Am. 2006 Jul;15(3):597-609. doi: 10.1016/j.chc.2006.02.006.
Symptoms of PTSD have been reported in response to a variety of life-threatening medical illnesses and injuries in adults and children. Emerging data suggest that children often experience medical treatment and hospitalization as traumatic, putting caregivers and medical personnel in the role of the unintended accomplice. Adequate pain control by pharmacologic and behavioral means; child and family psychological support using evidence-based CBT, dynamic psychotherapy, and other techniques; and meticulous attention to communication via a team-based approach are the cornerstones of pediatric palliative care in general and PTSD prevention and treatment in particular. Emerging evidence suggests that PTSD in life-limiting pediatric illness can be ameliorated, if not prevented, and treated when it occurs, contributing materially to the quality of life of a child and family. A landmark finding of PTSD research with medically ill children and their families is that parents are at least as symptomatic, or more, as their children, underlining the importance of a family-directed approach addressing every family mem-ber. Pediatric caregivers increasingly recognize their therapeutic role when curative therapy is no longer possible is as pivotal as in the setting of acute illness.
据报道，成人和儿童在经历各种危及生命的医疗疾病和伤害后会出现创伤后应激障碍（PTSD）症状。新出现的数据表明，儿童常常将医疗治疗和住院视为创伤性经历，这使得护理人员和医务人员成为了无意的同谋。通过药物和行为手段进行充分的疼痛控制；采用基于循证认知行为疗法（CBT）、动力心理治疗和其他技术为儿童及其家庭提供心理支持；以及通过团队协作方式精心关注沟通，这些都是儿童姑息治疗的基石，尤其是预防和治疗创伤后应激障碍的关键。新出现的证据表明，在患有危及生命疾病的儿童中，即使无法预防创伤后应激障碍，也可以对其进行改善，并且在其发生时进行治疗，这对儿童及其家庭的生活质量有重大贡献。对患有疾病的儿童及其家庭进行创伤后应激障碍研究的一个具有里程碑意义的发现是，父母至少与他们的孩子有同样多的症状，甚至更多，这凸显了以家庭为导向、关注每个家庭成员的方法的重要性。儿科护理人员越来越认识到，当治愈性治疗不再可行时，他们的治疗作用与在急性疾病情况下一样关键。
