MBBS, FRACGP, Senior Lecturer, Department of General Practice, Western Sydney University; General Practitioner, Blue Mountains Women@s Health and Resource Centre, Blue Mountains, NSW.
AO PhD, Emeritus Professor, Faculty of Medicine, University of Sydney, NSW.
Aust J Gen Pract. 2018 Jun;47(6):370-375. doi: 10.31128/AJGP-11-17-4406.
Trauma and adversity have serious health consequences, particularly when experienced in early life. These health consequences can be significantly lessened if young people access appropriate care when needed. In 2004, the Blue Mountains Women's Health and Resource Centre created a Young Women's Clinic (YWC) that began providing drop-in appointments for women aged 12-25 years with a general practitioner, nurse or counsellor, as well as a group art program.
A qualitative evaluation of services provided by the YWC was conducted, drawing on 13 years of client and staff experiences. The evaluation framework was drawn from the recommendations of the NSW Centre for Advancement of Adolescent Health, the Australian Women's Health Network and the World Health Organization report on People-centred and integrated health services.
The following principles of trauma-informed care were identified in the study: recognising the impact of trauma on consultations; tailoring consultation length to client needs; providing trauma therapy as well as physical healthcare; offering long-term, safe relationships with staff; trauma-sensitive gynaecological care; and the importance of self-care for health practitioners.
Our findings demonstrate the importance of holistic general practice services in preventing and managing the long-term health consequences of adversity and trauma.
创伤和逆境会对健康造成严重后果,尤其是在早年经历时。如果年轻人在需要时获得适当的护理,这些健康后果可以显著减轻。2004 年,蓝山妇女健康与资源中心成立了一个青年妇女诊所(YWC),开始为 12-25 岁的女性提供全科医生、护士或顾问的随到随诊服务,以及一个团体艺术项目。
对 YWC 提供的服务进行了定性评估,借鉴了 13 年来客户和工作人员的经验。评估框架取自新南威尔士州促进青少年健康中心、澳大利亚妇女健康网络和世界卫生组织关于以人为本和综合卫生服务的报告的建议。
研究中确定了以下创伤知情护理原则:认识到创伤对咨询的影响;根据客户需求调整咨询时长;提供创伤治疗以及身体保健;为员工提供长期、安全的关系;对妇科进行创伤敏感护理;以及卫生从业者自我保健的重要性。
我们的研究结果表明,整体全科医疗服务对于预防和管理逆境和创伤的长期健康后果非常重要。