創傷知情健康照護之實務

Implementation of Trauma-Informed Healthcare

極度壓力事件導致的創傷是影響人類健康的重要因子。經歷創傷的病人在醫療場域裡會以各種樣貌出現，包含被觸發創傷記憶而出現的強烈情緒或行為反應，無論是照護已知受創史的病人或是潛在受創者，對健康照護人員而言都是一大挑戰。創傷知情照護是以理解創傷為核心，尊重、同理及回應受創者的個別需求與反應，並能預防病人再度受創的照護方法。本文首先介紹創傷對健康的全面性影響，其後整理健康照護脈絡裡觸發創傷的因素，藉此突顯健康照護專業重視有受創史病人照護的必要性，最後，再將創傷知情的概念和原則融入健康照護實務中，以提供具體的實務應用策略。創傷知情健康照護實務需仰賴健康照護人員與機構組織共同努力，其原則包含健康照護人員的自我覺察與自我照顧、覺察病人創傷反應、確保病人安全感、建立信任感與照護透明度、與病人及健康照護團隊共同合作，並能在照護過程中提供選擇與增能。本文可作為健康照護人員提供受創病人友善且高品質照護之參考。

Trauma that is rooted in extremely stressful events is an important factor affecting human health. Patients who have experienced trauma may present in a variety of different ways in healthcare settings. One of these ways is the exhibiting of strong emotional or behavioral reactions triggered by traumatic memories. Caring for patients affected by known or unknown trauma is a significant challenge for healthcare providers. The core of trauma-informed care includes understanding trauma; respecting, empathizing and responding to the needs and reactions of patients with trauma; and providing care in a manner that prevents re-traumatization. In this article, the impact of trauma on overall health is introduced followed by a presentation of trauma triggers in the healthcare context, underscoring the importance of prioritizing care for patients with a history of trauma. Lastly, the concept and principles of trauma-informed care are incorporated into healthcare practice, providing specific, practical application strategies for healthcare providers to use in clinical settings. Trauma-informed healthcare practice relies on healthcare providers and organizations working together. The principles include the self-awareness and self-care of healthcare providers, awareness of the patient's trauma reaction, ensuring patient safety, building trust and transparency in care, working collaboratively with the patient and the healthcare team, and providing choices and empowerment during the care process. This article provides a reference to healthcare providers for providing friendly and high-quality care to patients with trauma.