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妇产科环境中的创伤知情护理

Trauma-Informed Care for Obstetric and Gynecologic Settings.

作者信息

Nagle-Yang Sarah, Sachdeva Jyoti, Zhao Lulu X, Shenai Neeta, Shirvani Nicole, Worley Linda L M, Gopalan Priya, Albertini Elizabeth S, Spada Meredith, Mittal Leena, Moore Simas Tiffany A, Byatt Nancy

机构信息

Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Place; MS F546, 80045, Aurora, CO, USA.

Departments of Psychiatry and Behavioral Neuroscience and Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, OH, USA.

出版信息

Matern Child Health J. 2022 Dec;26(12):2362-2369. doi: 10.1007/s10995-022-03518-y. Epub 2022 Nov 8.

Abstract

PURPOSE

Trauma is common among those seeking Ob-Gyn care and may have pervasive impact on obstetrical and gynecological health, social functioning, and healthcare engagement. While guidelines exist on the detection and treatment of perinatal mood and anxiety disorders within Ob-Gyn care, the role of Ob-gyn clinicians in identifying and addressing patients' traumatic experiences and related symptoms is less clearly delineated. This manuscript provides an overview of trauma-related symptoms in the context of Ob-Gyn care and practical guidance of clinicians aiming to improve their detection and response to trauma in their clinical practice.

DESCRIPTION

Posttraumatic stress disorder (PTSD) describes a psychiatric illness which develops as a response to a traumatic event. Women who have experienced trauma are also at increased risk for borderline personality disorder and other psychiatric comorbidities. Postpartum PTSD has particular relevance to obstetrical care.

ASSESSMENT

Screening for trauma in Ob-Gyn care can provide an opportunity to address risk and offer targeted intervention. Several brief evidence-based screening tools are available. Individuals who screen positive require assessment of immediate safety and targeted referrals. Trauma informed care describes an approach to healthcare aimed to enhance physical and emotional safety for patients and clinicians.

CONCLUSION

Given the prevalence and the potentially devastating and enduring impact of trauma and trauma-related symptoms, there is a critical need to address trauma within Ob-Gyn care. By recognizing the signs of trauma and initiating or referring to appropriate treatments, Ob-Gyn clinicians have a unique opportunity to better understand their patients and to improve their care.

摘要

目的

创伤在寻求妇产科护理的人群中很常见,可能会对妇产科健康、社会功能和医疗保健参与产生广泛影响。虽然在妇产科护理中存在围产期情绪和焦虑障碍的检测和治疗指南,但妇产科临床医生在识别和处理患者创伤经历及相关症状方面的作用尚不太明确。本文概述了妇产科护理背景下与创伤相关的症状,并为临床医生提供实用指导,旨在提高他们在临床实践中对创伤的检测和应对能力。

描述

创伤后应激障碍(PTSD)是一种因创伤事件而引发的精神疾病。经历过创伤的女性患边缘性人格障碍和其他精神共病的风险也会增加。产后创伤后应激障碍与产科护理尤为相关。

评估

在妇产科护理中筛查创伤可为处理风险和提供有针对性的干预提供机会。有几种基于证据的简短筛查工具可供使用。筛查呈阳性的个体需要评估即时安全性并进行有针对性的转诊。创伤知情护理描述了一种医疗保健方法,旨在增强患者和临床医生的身体和情感安全。

结论

鉴于创伤及与创伤相关症状的普遍性以及潜在的破坏性和持久性影响,在妇产科护理中处理创伤至关重要。通过识别创伤迹象并启动或转介适当治疗,妇产科临床医生有独特的机会更好地了解患者并改善护理。

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