Schippert Ana Carla S P, Grov Ellen Karine, Silvola Juha, Bjørnnes Ann Kristin
Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
Akershus University Hospital, Lørenskog, Norway.
BMC Surg. 2025 Aug 1;25(1):330. doi: 10.1186/s12893-025-03042-0.
A significant proportion of refugees and asylum seekers have experienced torture, leading to complex, long-term physical and psychological health needs. Many require surgical care for trauma-related injuries but often face barriers such as fear, mistrust, and a lack of trauma-specific knowledge among healthcare professionals. In surgical settings, the absence of trauma-informed practices can contribute to retraumatisation, misdiagnosis, and inadequate care. This narrative review provides an overview offering clinical insights to underscore the importance of trauma-informed, interdisciplinary approaches in the surgical care of torture survivors.
This narrative review is based on a targeted literature search conducted across PubMed, Google Scholar, Scopus, and Web of Science between August 2023 and January 2024. Relevant articles were identified through keyword-based searches and manual reference screening. The review focused on literature addressing somatic and surgical care for torture survivors, with an emphasis on trauma-informed approaches. An iterative process was used until thematic saturation was achieved.
Torture survivors frequently suffer from chronic physical conditions—such as brain injuries, fractures, contractures, hearing loss, and genitourinary damage—that may require surgical intervention. Despite these needs, they often face significant barriers to care, including fear, mistrust, and a lack of trauma-specific competence among healthcare professionals. The literature highlights that many survivors receive conflicting diagnoses and inadequate treatment within surgical services, contributing to confusion and loss of trust. Surgical teams are often unprepared to identify signs of torture or manage their complex psychological and physical effects. A trauma-informed, interdisciplinary approach is essential to address these gaps.
Surgical care for torture survivors must integrate trauma-informed practices at all stages to ensure safety, dignity, and effective treatment. Interdisciplinary collaboration is essential. Further research is needed to evaluate these approaches and understand their long-term impact on surgical treatment outcomes.
相当一部分难民和寻求庇护者经历过酷刑，导致出现复杂的长期身心健康需求。许多人因创伤相关损伤需要手术治疗，但往往面临诸多障碍，如恐惧、不信任，以及医疗保健专业人员缺乏创伤相关知识。在手术环境中，缺乏创伤知情做法可能导致再次创伤、误诊和护理不足。本叙述性综述提供了概述，给出临床见解，以强调创伤知情的跨学科方法在酷刑幸存者手术护理中的重要性。
本叙述性综述基于2023年8月至2024年1月在PubMed、谷歌学术、Scopus和科学网进行的有针对性的文献检索。通过基于关键词的搜索和手动参考文献筛选确定相关文章。该综述重点关注论述酷刑幸存者躯体和手术护理的文献，尤其强调创伤知情方法。采用迭代过程，直至达到主题饱和。
酷刑幸存者经常患有慢性身体疾病，如脑损伤、骨折、挛缩、听力丧失和泌尿生殖系统损伤，这些可能需要手术干预。尽管有这些需求，但他们在接受护理时往往面临重大障碍，包括恐惧、不信任，以及医疗保健专业人员缺乏创伤相关能力。文献强调，许多幸存者在手术服务中得到相互矛盾的诊断和不充分的治疗，导致困惑和信任丧失。手术团队往往没有准备好识别酷刑迹象或处理其复杂的心理和身体影响。创伤知情的跨学科方法对于弥补这些差距至关重要。
对酷刑幸存者的手术护理必须在各个阶段融入创伤知情做法，以确保安全、尊严和有效治疗。跨学科合作至关重要。需要进一步研究来评估这些方法，并了解它们对手术治疗结果的长期影响。
