McFarlane Alexander C, Bryant Richard A
Centre of Military and Veterans Health, University of Adelaide, 122 Frome Street, Adelaide, South Australia 5000, Australia.
Occup Med (Lond). 2007 Sep;57(6):404-10. doi: 10.1093/occmed/kqm070.
Post-traumatic stress disorder has had a substantial impact on employer liability for workplace psychological injury. The emergency services are an example of high-risk workforces that demand clear policies and procedures within an organization. The challenge is to minimize the injury to individuals and lessen the cost to organizations through the optimal application of preventative strategies.
This field is not well represented in standard keyword searches and Medline was examined with linked fields of practice and research. Consensus guidelines that refer to this domain were also utilized. Few conclusions can be reached from the literature which directly examined occupational settings.
Organizations need to anticipate the possible traumatic exposures that may affect the workforce and have strategies to deal with the effects in the workplace, particularly the negative mental health outcomes in some personnel. This domain is relevant to all employers as accidents and violence are possible in most workplaces. Screening should be considered for high-risk individuals, particularly following a major traumatic event or cumulative exposure, such as in the emergency services. While psychological debriefing has no demonstrated benefit, the benefits of early intervention necessitate ready access to evidence-based treatments that have minimum barriers to care. Employers should be aware that distress may present indirectly in a similar way as conflict with management, poor performance and poor general health.
The knowledge about the impact of traumatic events obliges employers to have an active strategy to anticipate and manage the aftermath of such events as well as cumulative traumatic exposures.
创伤后应激障碍对雇主在工作场所心理伤害方面的责任产生了重大影响。紧急服务部门就是高风险劳动力的一个例子，这类部门在组织内部需要明确的政策和程序。挑战在于通过优化预防性策略的应用，将对个人的伤害降至最低，并降低组织的成本。
该领域在标准关键词搜索中体现不足，因此对Medline数据库结合实践和研究的相关领域进行了审查。还采用了涉及该领域的共识指南。直接研究职业环境的文献得出的结论很少。
组织需要预测可能影响员工的创伤性暴露情况，并制定应对工作场所影响的策略，特别是应对一些员工出现的负面心理健康后果。由于大多数工作场所都可能发生事故和暴力事件，这一领域与所有雇主都相关。对于高风险个体，尤其是在经历重大创伤事件或累积暴露之后，比如在紧急服务部门工作的人员，应考虑进行筛查。虽然心理汇报并没有显示出益处，但早期干预的益处使得必须能够方便地获得障碍最小的循证治疗。雇主应该意识到，困扰可能会以与与管理层冲突、工作表现不佳和总体健康状况不佳类似的方式间接表现出来。
关于创伤性事件影响的知识要求雇主制定积极的策略，以预测和管理此类事件的后果以及累积的创伤性暴露。
