Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research Institute, Columbus, Ohio, USA.
Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Int J Gynecol Cancer. 2024 Jul 1;34(7):1077-1088. doi: 10.1136/ijgc-2024-005300.
Diagnosing, treating, and managing gynecologic cancer can lead to significant physical and emotional stress, which may have lasting effects on a patient's overall health and quality of life. The physical symptoms of gynecologic cancer, such as pain, discomfort, and loss of function, may also contribute to emotional distress and anxiety. Further, the diagnosis, treatment, and surveillance of gynecologic cancer may be traumatic due to the need for invasive exams and procedures, especially in women with a history of sexual assault or other traumatic experiences.Women with gynecologic cancer may experience various emotional and psychological symptoms, including anxiety, depression, post-traumatic stress disorder, and fear of recurrence. Trauma-informed care is an approach to healthcare that emphasizes the recognition and response to the impact of trauma on a patient's life. Further, trauma-informed care acknowledges that prior traumatic experiences may affect a patient's mental and physical health and that the healthcare system may unintentionally re-traumatize patients.Implementation of trauma-informed care can improve patient outcomes, increase patient satisfaction with care, and reduce the risk of re-traumatization during cancer treatment and follow-up care. Therefore, gynecologic oncology providers should become familiar with the principles and practices of trauma-informed care and implement trauma-informed screening tools to identify patients who may benefit from additional support or referrals to mental health services. This review will explore the importance of trauma-informed care in patients with gynecologic cancer and its impact on outcomes. Further, we discuss principles and evidence-based practices of trauma-informed care and strategies to implement trauma-informed screening tools to identify patients who may benefit from additional support or referrals to mental health services.
诊断、治疗和管理妇科癌症会导致显著的身体和情绪压力,这可能对患者的整体健康和生活质量产生持久影响。妇科癌症的身体症状,如疼痛、不适和功能丧失,也可能导致情绪困扰和焦虑。此外,由于需要进行侵入性检查和程序,特别是对于有性侵犯或其他创伤经历的女性,妇科癌症的诊断、治疗和监测可能会造成创伤。
患有妇科癌症的女性可能会经历各种情绪和心理症状,包括焦虑、抑郁、创伤后应激障碍和对复发的恐惧。以创伤知情照护为基础的护理方法强调认识和应对创伤对患者生活的影响。此外,以创伤知情照护为基础的护理承认先前的创伤经历可能会影响患者的身心健康,并且医疗保健系统可能会无意中使患者再次受到创伤。
实施以创伤知情照护为基础的护理可以改善患者的预后,提高患者对护理的满意度,并降低癌症治疗和随访期间再次创伤的风险。因此,妇科肿瘤学提供者应该熟悉以创伤知情照护为基础的护理原则和实践,并实施以创伤知情照护为基础的筛查工具,以确定可能需要额外支持或转介到心理健康服务的患者。
本综述将探讨以创伤知情照护为基础的护理在妇科癌症患者中的重要性及其对结局的影响。此外,我们还讨论了以创伤知情照护为基础的护理的原则和基于证据的实践,以及实施以创伤知情照护为基础的筛查工具以确定可能需要额外支持或转介到心理健康服务的患者的策略。