Høyvik Ann Catrin, Willumsen Tiril, Lie Birgit, Hilden Per Kristian
Dept. of Paediatric Dentistry, Behavioral Science and Forensic Dentistry, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Dean of Faculty of Dentistry, University of Oslo, Oslo, Norway.
Eur J Oral Sci. 2024 Oct;132(5):e13007. doi: 10.1111/eos.13007. Epub 2024 Jul 17.
Torture victims struggling with post-traumatic stress often experience elements in the dental treatment situation that may trigger trauma-related reactions. The aim of the study was to explore intervention strategies that will enable dental health workers to adapt dental treatment to the needs of torture survivors. Exploratory interviews were conducted with 10 torture-exposed resettled refugees with dental treatment experience in Norway. The data was analyzed using qualitative content analysis, which suggested that to minimize trauma-reactions, dental personnel should focus on creating a safe therapeutic space and strengthening the patient's sense of control. Four main categories of clinical advice were proposed: (i) Acquire knowledge about psychology, consequences of torture, cultural differences, trauma-informed care, and the patients' individual needs; (ii) Recognize the trigger-potential of busyness or delays; (iii) Avoid surprises, such as sudden moves or actions and explore triggers individually, but make sure not to evoke images of interrogation, and; (iv) Provide overview both with respect to visibility in the clinical room, and to predictability regarding the dental treatment. Although undergoing dental treatment may be challenging for torture-exposed individuals, it is possible to reduce the predicaments considerably by making feasible adaptions to the treatment and adopting a trauma-informed approach.
患有创伤后应激障碍的酷刑受害者在接受牙科治疗时，常常会遇到一些可能引发与创伤相关反应的情况。本研究的目的是探索干预策略，使牙科保健工作者能够根据酷刑幸存者的需求调整牙科治疗。对10名在挪威有牙科治疗经历的曾遭受酷刑的重新安置难民进行了探索性访谈。采用定性内容分析法对数据进行分析，结果表明，为了尽量减少创伤反应，牙科工作人员应专注于营造一个安全的治疗空间，并增强患者的控制感。提出了四类主要的临床建议：（i）了解心理学、酷刑的后果、文化差异、创伤知情护理以及患者的个人需求；（ii）认识到忙碌或延误引发问题的可能性；（iii）避免意外情况，如突然的动作或行为，并单独探究触发因素，但要确保不会唤起审讯的画面；（iv）在临床诊室的可见性和牙科治疗的可预测性方面提供总体情况。尽管接受牙科治疗对曾遭受酷刑的人来说可能具有挑战性，但通过对治疗进行可行的调整并采用创伤知情方法，可以大大减少困境。
