Discharge against Medical Advice in Surgical Patients with Posttraumatic Stress Disorder: A Case Report Series Illustrating Unique Challenges

Table 1

Interventions for consideration in surgical patients with PTSD [1, 2, 10–12].

Consideration	Intervention
Be proactive.	Identify history of AMA, poor compliance, or violence to better assess current risk.
	Provide social and psychological support.
	Provide realistic information about the postoperative period.
	Maintain open patient-doctor communication.
	Ensure the continuation of medication for PTSD while being in the hospital.
Be aware and prepared.	Develop collaborative approaches and effective rescue strategies that could be implemented as soon as the patient wishes to leave AMA.
	Handle aggressive and hostile behaviors in a productive and constructive way.
	Avoid getting upset or frustrated; instead, be positive and encouraging.
	Try to reduce the danger of losing the patient’s trust by utilizing communication that emphasizes understanding of their unique issues with cultural sensitivity.
Decrease stigma.	Actively maintain the patient-doctor-relationship, ensuring proper follow-up.

Note. AMA = against medical advice; PTSD = posttraumatic stress disorder.