重大災難後燒傷病人的心理重建

The Mental Rehabilitation of Burn Patients After a Major Disaster

台灣近十餘年重大災難頻傳，災難已經不是特例，而是常態的一部分，因此，心理重建變成精神醫學的重大課題之一，面對災難所需要的緊急處置應是專業內化的一部分。台灣近年來的兩大重大人為災難—氣爆與塵爆，造成許多燒傷倖存者。個案因身體心像變形與工作問題，會直接或間接影響到其精神及情緒狀態。燒傷者常見精神疾病以重鬱症、廣泛性焦慮症與創傷後壓力疾患最多，其中廣泛性焦慮症與創傷後壓力疾患的共病是最高的。為減少日後的心理問題，在創傷初期，心理專業人員就應儘速採取心理急救（psychologi cal first aid, PFA），以滿足燒傷者的情緒需求。面對重大的身體創傷，復健是一個漫長的道路，而心理重建又是整體重建很重要的一環。因此，面對燒傷病人，心理專業人員應在第一時間採取心理急救，同時，在其出院後的長期心理重建也不可忽視。

Many catastrophic disasters have happened in Taiwan over the last decade. As disaster is not a special occurrence but rather a part of the norm, mental rehabilitation should be treated as a mainstream issue in psychiatry. The internalization of emergency psychological interventions is necessary for every mental-health professional. The two primary categories of major manmade disasters in Taiwan over the past decade have been gas explosions and powder burns. Both categories have led to the serious injury of many individuals. The physical deformities and job problems faced by burn patients affect their psychiatric and emotional states both directly and indirectly. The psychiatric comorbidities of burn patients include: major depression, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD), with GAD and PTSD comprising the most significant comorbidities in terms of numbers of diagnoses. To reduce psychological problems in the future, mental-health professionals should use appropriate psychological first aid (PFA) interventions in the early stages of treatment and rehabilitation. Mental rehabilitation is a major and comprehensive rehabilitation process. Mental-health professionals should thus use PFA to treat burn patients as well as provide long-term mental rehabilitation after discharge.