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Public defence: Ana Carla Soares Portugal Schippert

Ana Carla Soares Portugal Schippert will defend her PhD in Health Sciences.

Thesis title: Giving Torture Survivors a Voice: Developing Guidelines to Prevent Re-traumatization During Surgical Care.

The ordinary opponents are:

The leader of the public defence is Ingrid Ruud Knutsen.

The supervisor is Ann Kristin Bjørnnes, Faculty of Health Sciences, OsloMet. The co-supervisors are Tone Dahl-Michelsen, OsloMet, Ellen Karine Grov, OsloMet, and Juha Silvola, University of Oslo.

  • Thesis summary

    There is widespread understanding that refugees and asylum seekers who have undergone torture have specific health needs. The journey to resettlement has problems that continue before, during, and after arrival in the new country.

    Unfortunately, survivors seeking healthcare, particularly in surgical departments, face extra challenges, risking re-traumatization.

    While certain healthcare fields, such as dentistry, have adopted precautions for traumatized survivors, surgical departments lack practical adaptations and guidelines, exposing torture survivors at risk of re-traumatization.

    Developing guidelines

    This thesis fills that gap by developing guidelines to prevent re-traumatization during surgical care for torture survivors.

    The guidelines, divided into ten categories, address the full patient journey from admission to discharge in surgical care. The recommendations were developed based on the findings from the project's four stages.

    The systematic reviews revealed the barriers that refugees and asylum seekers encounter in accessing somatic healthcare and treatment-related stressors.

    The first qualitative study indicated survivors' challenges with re-traumatization during surgical care, which intensified memories and elicited emotional and physiological responses.

    In the second qualitative study, healthcare practitioners acknowledged obstacles in assisting survivors' specific needs.

    Healthcare professionals assessed the guidelines, which they saw as essential for raising knowledge about torture and its consequences, as well as an important tool for helping healthcare workers prevent re-traumatization.

    Ten guidelines

    The guidelines include following sections:

    • Recommendations for identifying torture survivors
    • Recommendations for using interpreters
    • Recommendations for welcoming patients before surgery
    • Recommendations for physical examinations
    • Recommendations for preventing re-traumatization during local anesthesia procedures
    • Recommendations for transporting patients to the operating theater
    • Recommendations for managing triggers in the operating theater
    • Recommendations for administering general anesthesia to torture survivors
    • Recommendations for post-surgical assessment and treatment
    • Recommendations for handling re-traumatization indicators.

    This comprehensive thesis addresses the lack of guidelines in surgical departments for torture survivors, providing guidelines including practical recommendations for healthcare professionals.

    The findings underscore the importance of healthcare professionals awareness, sensitivity and practical adjustments throughout the surgical care process to prevent re-traumatization in torture survivors.


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