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截肢患者的同伴咨询:创伤外科中一种略有不同的手段

[Peer counseling for amputations : A somewhat different instrument in trauma surgery].

作者信息

Beirau Melissa, Zappel Kristina, Güthoff Claas, Steinbach Anne, Ekkernkamp Axel

机构信息

Klinik für Unfallchirurgie und Orthopädie, BG Klinikum Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Deutschland.

Behandlungszentrum für Rückenmarkverletzte, BG Klinikum Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Deutschland.

出版信息

Unfallchirurgie (Heidelb). 2024 Sep;127(9):644-650. doi: 10.1007/s00113-024-01459-5. Epub 2024 Jul 20.

Abstract

The abrupt onset of the situation after a traumatic amputation and the preparatory discussions following unsuccessful attempts to preserve limbs with necessary amputation require a high level of empathy, attention and well-founded information individually tailored to the affected individuals. Optimization of the treatment process can only be achieved by considering these aspects.The self-motivation and cooperation of the patient should be encouraged. To achieve this goal, the professions involved are less suitable for counseling due to a lack of personal experience, whereas so-called peers, as knowledgeable and experienced advisors, are more appropriate. This insight can be derived from existing studies. Peer counseling has increasingly been integrated into routine treatment following amputations in trauma surgery, with positive effects. It is considered guideline-compliant therapy not only in rehabilitation. Against the background of long-standing legislation, especially the UN Convention on the Rights of Persons with Disabilities and the demands of those affected by amputation, the following presentation focuses on the instrumentalization and benefits of counseling. The structures of this particular counseling option, including regular training of counselors and established implementation, are currently not necessarily given but are continuously expanding and being adapted to needs. Concrete scientific evidence regarding measurable effects and positive impacts on outcomes is pending and are presented in a current research project.

摘要

创伤性截肢后情况的突然出现,以及在试图保留肢体但未成功而不得不进行截肢后的准备性讨论,都需要高度的同理心、关注以及为受影响个体量身定制的有充分依据的信息。只有考虑到这些方面,治疗过程才能实现优化。应鼓励患者的自我激励与合作。为实现这一目标,由于缺乏个人经验,相关专业人员不太适合提供咨询,而所谓的同龄人作为知识渊博且经验丰富的顾问则更为合适。这一见解可从现有研究中得出。同伴咨询已越来越多地融入创伤外科截肢后的常规治疗中,并产生了积极效果。它不仅在康复领域被视为符合指南的治疗方法。在长期立法的背景下,尤其是《联合国残疾人权利公约》以及截肢患者的需求,以下介绍将重点关注咨询的工具化作用和益处。这种特殊咨询方式的结构,包括对咨询师的定期培训和既定的实施方式,目前不一定具备,但正在不断扩展并适应需求。关于可测量效果和对结果的积极影响的具体科学证据尚待确定,并在当前的一个研究项目中呈现。

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