Winkler Olga, Burback Lisa, Greenshaw Andrew J, Jin Jonathan
Department of Psychiatry, University of Alberta, Edmonton, Canada.
Case Rep Psychiatry. 2023 Jan 23;2023:8161010. doi: 10.1155/2023/8161010. eCollection 2023.
Caring for patients with personality disorders can be challenging due to risks associated with suicidal ideation, homicidal threats, splitting, and acting out with problematic behavior in psychiatric inpatient units. Limited resources on inpatient units further add to the stress and burden on staff. This case summarizes how trauma-informed care was implemented in an inpatient setting to produce marked improvement in a patient's treatment outcomes as well as better staff engagement and satisfaction. This culture change in the approach to care was not an easy process, as effortful planning and resources were required for key elements such as ongoing coaching, education, and regular staff debriefings. This case report signals the need for service providers to enable health systems to examine rules and exceptions from a cultural perspective of considering equity, diversity, and inclusion (EDI)-to allow openness to rational exceptions, even if they are unconventional.
由于精神科住院病房中存在与自杀意念、杀人威胁、分裂以及问题行为发作相关的风险,护理人格障碍患者可能具有挑战性。住院病房资源有限,这进一步加重了工作人员的压力和负担。本案例总结了如何在住院环境中实施创伤知情护理,从而使患者的治疗结果得到显著改善,同时提高工作人员的参与度和满意度。护理方式的这种文化转变并非易事,因为持续指导、教育和定期工作人员汇报等关键要素需要精心规划和资源投入。本案例报告表明,服务提供者需要促使卫生系统从考虑公平、多样性和包容性(EDI)的文化视角审视规则和例外情况,以便能够接受合理的例外,即使这些例外是非传统的。