Elisseou Sadie
Department of Medicine, Harvard Medical School, Boston, MA, USA.
Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
J Healthc Leadersh. 2023 Aug 21;15:169-173. doi: 10.2147/JHL.S389271. eCollection 2023.
The Covid-19 pandemic and national movements for health equity have highlighted the impact of trauma on public health as well as on health worker well-being. As burnout rates across healthcare climb, we seek creative and effective solutions. Current anti-burnout strategies focus on much needed systems solutions for employee success; however, they often lack a trauma-informed approach. Trauma is highly prevalent in society at large, and health workers are further exposed to trauma in the course of their professional studies and duties. Common symptoms of burnout may actually be manifestations of traumatic stress. Trauma-informed care (TIC) is a strategic framework and growing social movement for providing quality care to survivors of individual, interpersonal, collective, and structural trauma. Importantly, TIC has practical applications to address our healthcare burnout epidemic. In this perspective piece, an expert describes a trauma-informed lens through which to view burnout solutions using SAMHSA's 4 Rs of a trauma-informed approach: 1) Realize the widespread impact of trauma, 2) Recognize the signs and symptoms in patients and staff, 3) Respond by integrating knowledge about trauma into practice, and actively 4) Resist re-traumatization. Moving forward, key stakeholders must collaborate to build and refurbish efficient systems alongside a trauma-informed organizational model. TIC can transform the healthcare experience for patients and employees alike by fostering community, empowerment, and healing.
新冠疫情以及全国范围内促进健康公平的运动凸显了创伤对公众健康以及医护人员福祉的影响。随着整个医疗行业倦怠率的攀升，我们在寻求创新且有效的解决方案。当前的抗倦怠策略侧重于为员工的成功提供急需的系统解决方案；然而，这些策略往往缺乏一种考虑创伤因素的方法。创伤在整个社会中极为普遍，医护人员在专业学习和工作过程中会进一步接触到创伤。倦怠的常见症状实际上可能是创伤应激的表现。创伤知情护理（TIC）是一个战略框架，也是一场不断发展的社会运动，旨在为个人、人际、集体和结构性创伤的幸存者提供高质量护理。重要的是，创伤知情护理在解决我们医疗行业的倦怠流行问题方面具有实际应用价值。在这篇观点文章中，一位专家描述了一种创伤知情视角，通过美国药物滥用和精神健康服务管理局（SAMHSA）的创伤知情方法的4个R来审视倦怠解决方案：1）认识到创伤的广泛影响，2）识别患者和工作人员身上的体征和症状，3）通过将创伤知识融入实践来做出回应，以及4）积极防止再次创伤。展望未来，关键利益相关者必须合作，以建立和完善高效的系统，并采用一种考虑创伤因素的组织模式。创伤知情护理可以通过促进社区、赋权和康复，改变患者和员工的医疗体验。
