Boston University School of Public Health, Boston, Massachusetts, USA.
JAMA. 2013 Aug 7;310(5):519-28. doi: 10.1001/jama.2013.8788.
Refugees are a vulnerable class of immigrants who have fled their countries, typically following war, violence, or natural disaster, and who have frequently experienced trauma. In primary care, engaging refugees to develop a positive therapeutic relationship is challenging. Relative to care of other primary care patients, there are important differences in symptom evaluation and developing treatment plans.
To discuss the importance of and methods for obtaining refugee trauma histories, to recognize the psychological and physical manifestations of trauma characteristic of refugees, and to explore how cultural differences and limited English proficiency affect the refugee patient-clinician relationship and how to best use interpreters.
MEDLINE and the Cochrane Library were searched from 1984 to 2012. Additional citations were obtained from lists of references from select research and review articles on this topic.
Engagement with a refugee patient who has experienced trauma requires an understanding of the trauma history and the trauma-related symptoms. Mental health symptoms and chronic pain are commonly experienced by refugee patients. Successful treatment requires a multidisciplinary approach that is culturally acceptable to the refugee.
Refugee patients frequently have experienced trauma requiring a directed history and physical examination, facilitated by an interpreter if necessary. Intervention should be sensitive to the refugee's cultural mores.
难民是一个弱势群体，他们逃离自己的国家，通常是因为战争、暴力或自然灾害，并经常经历创伤。在初级保健中，与难民建立积极的治疗关系具有挑战性。与其他初级保健患者相比，在评估症状和制定治疗计划方面存在重要差异。
讨论获取难民创伤史的重要性和方法，认识难民创伤的心理和身体表现，并探讨文化差异和有限的英语水平如何影响难民患者-临床医生关系，以及如何最好地使用口译员。
从 1984 年到 2012 年，在 MEDLINE 和 Cochrane 图书馆进行了搜索。从本主题的一些研究和综述文章的参考文献列表中获得了其他引文。
与经历过创伤的难民患者接触需要了解创伤史和与创伤相关的症状。心理健康症状和慢性疼痛是难民患者常见的症状。成功的治疗需要一种多学科的方法，这种方法对难民来说是文化上可以接受的。
难民患者经常经历需要进行定向病史和体检的创伤，如有必要，可以通过口译员进行协助。干预措施应考虑到难民的文化习俗。
