Schreiber Merritt, Cates David S, Formanski Stephen, King Michael
David Geffen School of Medicine at UCLA, Department of Pediatrics, LA Biomedical Research Institute at Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA.
University of Nebraska Medical Center, Department of Psychiatry, Nebraska Medicine, Department of Psychology, 984185 Nebraska Medical Center, Omaha, NE.
Mil Med. 2019 Mar 1;184(Suppl 1):114-120. doi: 10.1093/milmed/usy400.
There is increasing knowledge that health care workers (HCWs) can experience a variety of emotional impacts when responding to disasters and terrorism events. The Anticipate, Plan and Deter (APD) Responder Risk and Resilience Model was developed to provide a new, evidence-informed method for understanding and managing psychological impacts among HCWs. APD includes pre-deployment development of an individualized resilience plan and an in-theater, real-time self-triage system, which together allow HCWs to assess and manage the full range of psychological risk and resilience for themselves and their families. The inclusion of objective mental health risk factors to prompt activation of a coping plan, in connection with unit leadership real-time situational awareness, enables the first known evidence-driven "targeted action" plan to address responder risk early before Post Traumatic Stress Disorder and impairment become established. This paper describes pilot work using the self-triage system component in Alameda County's Urban Shield and the Philippines' Typhoon Haiyan, and then reports a case example of the full APD model implementation in West Africa's Ebola epidemic.
人们越来越认识到，医护人员在应对灾难和恐怖主义事件时可能会受到各种情绪影响。“预期、规划与预防”（APD）应急人员风险与复原力模型的开发，旨在提供一种新的、基于证据的方法，以理解和管理医护人员的心理影响。APD包括部署前制定个性化的复原力计划和战区实时自我评估系统，这两者共同使医护人员能够为自己和家人评估并管理全方位的心理风险和复原力。纳入客观的心理健康风险因素以促使应对计划启动，并结合单位领导的实时态势感知，形成了首个已知的基于证据驱动的“针对性行动”计划，以便在创伤后应激障碍和功能损害形成之前尽早应对应急人员风险。本文描述了在阿拉米达县的“城市盾牌”演习和菲律宾的台风“海燕”中使用自我评估系统组件的试点工作，然后报告了在西非埃博拉疫情中全面实施APD模型的一个案例。
