Medical Service, Section of Palliative Care, 20026Veterans Affairs Boston Healthcare System, Boston, MA, USA.
Department of Medicine, Harvard Medical School, Boston, MA, USA.
Am J Hosp Palliat Care. 2023 Mar;40(3):329-336. doi: 10.1177/10499091221116098. Epub 2022 Jul 18.
Many individuals who present for hospice or palliative care might have experienced trauma during their lives, with some progressing to post-traumatic stress disorder. As these individuals face life-limiting illness, trauma might resurface. Consequently, physical and emotional health might suffer due to exacerbation of trauma-related symptoms, such as anxiety, irritability, or flashbacks. Providing trauma-informed care can help mitigate the effects of trauma for those facing life-limiting illness who might not be able to tolerate formal trauma treatment due to limited prognosis, fatigue, or lack of willingness to engage in treatment. The goal of this narrative review is to describe how aging and the end-of-life experience can lead to a re-engagement with previous traumatic experiences and, using case-based examples, provide recommendations for all members of the interprofessional hospice or palliative care team on how to elicit and respond to a history of trauma to minimize the potential negative impact of trauma at end-of-life.
许多前来接受临终关怀或姑息治疗的人在其一生中可能经历过创伤，其中一些人发展为创伤后应激障碍。当这些人面临危及生命的疾病时，创伤可能会再次出现。因此，由于与创伤相关的症状（如焦虑、易怒或闪回）加剧，他们的身心健康可能会受到影响。提供创伤知情护理可以帮助减轻那些面临危及生命的疾病的人的创伤影响，这些人由于预后有限、疲劳或不愿意接受治疗，可能无法忍受正式的创伤治疗。本叙述性综述的目的是描述衰老和生命末期的经历如何导致重新接触以前的创伤经历，并通过案例示例，为姑息治疗团队的所有专业人员提供有关如何引出和应对创伤史的建议，以尽量减少生命末期创伤的潜在负面影响。
