Dowdell Elizabeth B, Speck Patricia M
Elizabeth B. Dowdell is a professor and coordinator of undergraduate research at Villanova University, Villanova, PA. Patricia M. Speck is a professor and coordinator of advanced forensic nursing at the University of Alabama at Birmingham School of Nursing. Contact author: Elizabeth B. Dowdell,
Am J Nurs. 2022 Apr 1;122(4):30-38. doi: 10.1097/01.NAJ.0000827328.25341.1f.
Over the past 30 years, researchers have found that childhood trauma and its subsequent stress have a strong and cumulative effect on health in adulthood. Trauma in childhood often leads to mental health problems, skeletal fractures, and early death from conditions such as heart disease, cancer, lung disease, and liver disease. Compounding the effects of traumatic stress, health care systems often create a population of "never-served" persons who avoid health care settings because they've been subject to judgment and marginalization. Trauma-informed care (TIC) is a skill underutilized by health care providers and organizations, yet nurse ethics and respect for human rights require us to care for all patients equally without judgment, including those living with the stress of complex trauma. The TIC approach respects human rights and supports nursing ethics, promoting a welcoming, inclusive environment in health care systems and patient-provider relationships that eschews implicit and explicit bias toward patients, regardless of presentation or personal circumstances. TIC foundational principles guide the application of the nursing process using patient-centered care to create safety, the first principle in TIC. Here, the authors discuss the application of these core principles in nursing through a deidentified case study.
在过去30年里,研究人员发现童年创伤及其后续压力对成年后的健康有着强烈的累积影响。童年创伤往往会导致心理健康问题、骨骼骨折,以及因心脏病、癌症、肺病和肝病等疾病而过早死亡。除了创伤性压力的影响之外,医疗保健系统常常造成一群“从未得到过治疗”的人,他们避开医疗保健机构,因为他们遭受过评判和边缘化。创伤知情护理(TIC)是医疗保健提供者和机构未充分利用的一项技能,然而护士的职业道德和对人权的尊重要求我们平等地关爱所有患者,不加评判,包括那些承受着复杂创伤压力的患者。创伤知情护理方法尊重人权并支持护理伦理,在医疗保健系统以及医患关系中营造一个友好、包容的环境,避免对患者产生隐性和显性偏见,无论患者的表现或个人情况如何。创伤知情护理的基本原则指导护理程序的应用,采用以患者为中心的护理来营造安全的环境,这是创伤知情护理的首要原则。在此,作者通过一个匿名案例研究来探讨这些核心原则在护理中的应用。