Guess Katherine E, Fifolt Matthew, Adams Raeanna C, Ford Eric W, McCormick Lisa C
University of Arkansas for Medical Sciences, Little Rock (Dr Guess); Departments of Health Behavior (Dr Guess), Health Care Organization and Policy (Drs Fifolt and Ford), and Environmental Health Science (Dr McCormick), School of Public Health, University of Alabama at Birmingham; and Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Adams).
J Trauma Nurs. 2019 Sep/Oct;26(5):223-233. doi: 10.1097/JTN.0000000000000451.
Patients admitted to Level 1 trauma centers in the United States are rarely assessed for or educated about the potentially devastating effects of acute stress disorder (ASD) or posttraumatic stress disorder (PTSD). This descriptive research was conducted to describe current levels of assessment and education of ASD and PTSD in Level 1 trauma centers in the United States. The aims of this article are to (1) determine the extent to which Level 1 trauma centers in the United States assess and educate patients and providers about ASD and PTSD and (2) identify clinical staff who administer assessments and provide educational resources. A web-based survey was distributed to the trauma program managers and trauma medical directors of 209 adult and 70 pediatric Level 1 trauma centers in the United States. For PTSD, 26 (25.00%) adult and 17 (36.17%) pediatric centers had an assessment protocol for use with trauma patients. For ASD, 13 (12.50%) adult and 13 (27.66%) pediatric centers utilized an assessment protocol for use with trauma patients. For PTSD, 12 (12.37%) adult and 8 (20.00%) pediatric centers offered educational protocols for use with trauma patients. Seven (7.22%) adult and 7 (17.50%) pediatric centers maintain educational protocols for ASD in trauma patients. Fewer centers had assessment or educational protocols targeting formal and informal caregivers. This study was limited to Level 1 trauma centers in the United States. Results indicate that trauma patients are rarely assessed for or educated about the potential effects of PTSD or ASD. Formal and informal caregivers are also assessed and educated at low rates. Assessment, education, and incidence of PTSD and ASD should be included as universally measured health outcomes across trauma centers.
在美国，一级创伤中心收治的患者很少接受关于急性应激障碍（ASD）或创伤后应激障碍（PTSD）潜在破坏性影响的评估或教育。本描述性研究旨在描述美国一级创伤中心对ASD和PTSD的评估及教育现状。本文的目的是：（1）确定美国一级创伤中心对患者及医护人员进行ASD和PTSD评估及教育的程度；（2）确定进行评估并提供教育资源的临床工作人员。一项基于网络的调查被分发给了美国209家成人一级创伤中心和70家儿科一级创伤中心的创伤项目管理人员及创伤医疗主任。对于PTSD，26家（25.00%）成人中心和17家（36.17%）儿科中心有针对创伤患者的评估方案。对于ASD，13家（12.50%）成人中心和13家（27.66%）儿科中心采用了针对创伤患者的评估方案。对于PTSD，12家（12.37%）成人中心和8家（20.00%）儿科中心提供了针对创伤患者的教育方案。7家（7.22%）成人中心和7家（17.50%）儿科中心为创伤患者制定了ASD教育方案。针对正式和非正式护理人员的评估或教育方案的中心较少。本研究仅限于美国的一级创伤中心。结果表明，创伤患者很少接受关于PTSD或ASD潜在影响的评估或教育。正式和非正式护理人员接受评估和教育的比例也很低。PTSD和ASD的评估、教育及发病率应作为创伤中心普遍衡量的健康指标纳入考量。
