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探索创伤后应激障碍患者的护理与康复:一项范围综述

Exploring Care and Recovery for Individuals With Post-traumatic Stress Disorder: A Scoping Review.

作者信息

Smith Jennifer R, Drouillard Kyle J, Foster Angel M

机构信息

Faculty of Health Sciences, University of Ottawa, Ottawa, CAN.

出版信息

Cureus. 2024 Feb 6;16(2):e53741. doi: 10.7759/cureus.53741. eCollection 2024 Feb.

Abstract

Most people experience trauma at some point in their lives. The sources of trauma can include accidents, natural disasters, physical or sexual assault, combat, torture, or the death of a loved one. Experiencing or witnessing any of these, or other terrifying events, may make one susceptible to developing post-traumatic stress disorder (PTSD), a trauma- and stressor-related mental health condition. The common symptoms and consequences of PTSD include intrusive and distressing thoughts, memories, or flashbacks related to the traumatic event; avoidance of situations, people, or activities that remind one of the traumatic event; irritability, sleep difficulties, or hypervigilance; feelings of guilt, shame, or fear; substance use; strains on relationships; and suicidal thoughts and behaviors. These consequences can have devastating effects on the individual and their family members, friends, co-workers, peers, and communities. Effectively treating PTSD, therefore, is critical not only for the individual but also for the well-being of families, communities, and society at large. However, while treatments for PTSD exist, effectively treating patients with PTSD remains elusive. Further, despite the recognition that people's experiences are essential in understanding PTSD and provide valuable insights into what interventions are effective and how they impact recovery, patient perspectives and experiences of care and recovery have not been well-explored. We conducted a scoping review to address the following question: what is known about the experiences and perspectives of care and recovery for individuals with PTSD? We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, American Psychological Association's (APA) PsycInfo, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PTSDPubs, and Google Scholar for peer-reviewed and grey literature that used qualitative methods to report on the recovery or care experiences of adults with lived experiences of PTSD. We extracted information about study objectives, study characteristics, and key findings; reported summary statistics; and performed content and thematic analyses. We identified 14 relevant studies that provide insight into the participants' lived experiences and perspectives of PTSD care and recovery. Though limited, the body of literature sheds light on critical themes and processes in the journey of care of PTSD, which we organized into four overarching categories: pre-treatment understanding and experiences of PTSD, the experience of care or treatment, the importance of relationships and social support, and expanding the understandings of recovery. Living with and healing from PTSD are a unique and individualized human experience of developing and redeveloping relationships with oneself, with others, and with society. The recommendations for practice include educating and establishing well-informed support networks for individuals with PTSD, training healthcare practitioners in all aspects of formal and informal PTSD treatment and care needs, ensuring a continuum of care, and understanding the human experience of PTSD.

摘要

大多数人在生命中的某个时刻会经历创伤。创伤的来源可能包括事故、自然灾害、身体或性侵犯、战斗、酷刑或亲人的死亡。经历或目睹这些事件中的任何一个,或其他可怕的事件,可能会使人易患创伤后应激障碍(PTSD),这是一种与创伤和应激源相关的心理健康状况。PTSD的常见症状和后果包括与创伤事件相关的侵入性和痛苦的想法、记忆或闪回;避免那些会让人想起创伤事件的情况、人或活动;易怒、睡眠困难或过度警觉;内疚、羞耻或恐惧的感觉;物质使用;人际关系紧张;以及自杀念头和行为。这些后果会对个人及其家庭成员、朋友、同事、同龄人以及社区产生毁灭性影响。因此,有效治疗PTSD不仅对个人至关重要,对家庭、社区乃至整个社会的福祉也至关重要。然而,尽管存在针对PTSD的治疗方法,但有效治疗PTSD患者仍然难以实现。此外,尽管人们认识到个人经历对于理解PTSD至关重要,并能为哪些干预措施有效以及它们如何影响康复提供有价值的见解,但患者对护理和康复的观点及经历尚未得到充分探索。我们进行了一项范围综述,以解决以下问题:关于PTSD患者的护理和康复经历及观点,我们了解到了什么?我们在医学文献分析与检索系统在线数据库(MEDLINE)、Embase、美国心理学会(APA)的PsycInfo、护理及相关健康文献累积索引数据库(CINAHL)、PTSDPubs以及谷歌学术中搜索了同行评审文献和灰色文献,这些文献采用定性方法报告了有PTSD生活经历的成年人的康复或护理经历。我们提取了有关研究目标、研究特征和主要发现的信息;报告了汇总统计数据;并进行了内容和主题分析。我们确定了14项相关研究,这些研究为参与者的PTSD护理和康复生活经历及观点提供了见解。尽管文献有限,但这一文献主体揭示了PTSD护理过程中的关键主题和过程,我们将其归纳为四个总体类别:创伤后应激障碍的治疗前理解与经历、护理或治疗经历、人际关系和社会支持的重要性以及对康复理解的扩展。与创伤后应激障碍共存并从中康复是一种独特且个性化的人类经历,涉及与自己、他人以及社会建立和重新建立关系。实践建议包括为PTSD患者提供教育并建立知识丰富的支持网络,对医疗从业者进行正式和非正式PTSD治疗及护理需求各方面的培训,确保连续护理,并理解PTSD的人类经历。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e972/10920405/a6d922710ac9/cureus-0016-00000053741-i01.jpg

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