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每年,自然灾害、技术灾害和大型暴力冲击了美国数百万人。灾害后,提供初级保健服务的时间要增至12个月或更长。帮助受害者的概念框架包括,理解灾害后影响身心健康的个体和环境风险因素。灾害的受害者呈现给家庭医生的典型问题包括急性躯体健康问题,如胃肠炎或病毒综合征。慢性问题常需要药物治疗和提供初级保健服务。有些受害者可存在急性或者慢性身心问题的风险性,如创伤后应激障碍、抑郁症或者酒精依赖。灾害后出现身心健康问题的风险因素包括,灾害前的心理健康问题和高水平暴露于灾害相关的应激源(如对死亡或者严重创伤的担心、暴露于严重创伤或者死亡、与家庭分离,长时间迁居)。对灾害有效的行动计划需要做好充分的准备工作。针对灾害对身心健康的威胁性,家庭医生应该做好自我教育,并且与地方和国家相关组织机构进行配合;保证诊所或办公场所有充足的药品、缝合和打石膏用品等医疗资源。医生也应该对其家庭安全做出应有的计划。
Each year, natural disasters, technological disasters and large-scale violence impact millions of people in the United States. After the disaster, the time to provide primary health care services will increase to 12 months or longer. The conceptual framework for helping victims includes understanding individual and environmental risk factors that affect physical and mental health after a disaster. Typical problems that victims of disasters present to family doctors include acute physical health problems such as gastroenteritis or viral syndrome. Chronic problems often require medications and primary care services. Some victims may be at risk of acute or chronic physical and mental problems such as post-traumatic stress disorder, depression or alcohol dependence. Risk factors for physical and mental health problems after a disaster include pre-disaster mental health problems and high levels of exposure to disaster-related stressors (eg, fear of death or serious trauma, exposure to severe trauma or death, separation from the family, long Time to move). Effective action plans for disasters need to be fully prepared. In response to the threat to physical and mental health caused by disasters, family doctors should educate themselves and cooperate with local and national relevant organizations; ensure that the clinic or office has adequate medical resources such as medicines, sutures, and gypsum supplies. Doctors should also make due plans for their family safety.