Flynn Anna B, Fothergill Kate E, Wilcox Holly C, Coleclough Elizabeth, Horwitz Russell, Ruble Anne, Burkey Matthew D, Wissow Lawrence S
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
Acad Pediatr. 2015 Sep-Oct;15(5):480-92. doi: 10.1016/j.acap.2015.06.012.
To systematically assess the evidence base for prevention and treatment of child traumatic stress in primary care settings.
PubMed, Embase, PsycINFO, Scopus, Academic Search Complete, CINAHL, Web of Science, Cochrane Library, the National Registry of Evidence-based Programs and Practices, the National Child Traumatic Stress Network website, Google search.
STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Studies were eligible for inclusion if they described the results of intervention studies in a primary care setting addressing child traumatic stress. Study participants could include primary care providers, pediatric patients, and their parents or other caregivers.
Each study was assessed for inclusion, and each included study was assessed for risk of bias by 2 reviewers.
We found 12 articles describing 10 different studies that met the inclusion criteria. The intervention approaches taken in the studies were diverse and included the implementation of screening programs or tools, training clinicians to recognize and discuss psychosocial issues with patients and their families, and providing primary care professionals with community resource lists. Nine out of 10 studies included in the review reported favorable results.
Studies included in the review had relatively short follow-up periods, and the diversity of studies identified precluded the possibility of conducting a meta-analysis.
Findings suggest that interventions in pediatric primary care settings are feasible and can favorably affect clinical practices and families' outcomes.
系统评估在初级保健机构中预防和治疗儿童创伤后应激障碍的证据基础。
PubMed、Embase、PsycINFO、Scopus、Academic Search Complete、CINAHL、Web of Science、Cochrane图书馆、基于证据的项目和实践国家注册库、国家儿童创伤应激网络网站、谷歌搜索。
研究入选标准、参与者和干预措施：如果研究描述了在初级保健机构中针对儿童创伤后应激障碍的干预研究结果，则符合纳入条件。研究参与者可能包括初级保健提供者、儿科患者及其父母或其他照顾者。
评估每项研究是否符合纳入条件，由两名评审员对每项纳入研究的偏倚风险进行评估。
我们发现12篇文章描述了10项符合纳入标准的不同研究。研究中采用的干预方法多种多样，包括实施筛查项目或工具、培训临床医生识别并与患者及其家属讨论心理社会问题，以及为初级保健专业人员提供社区资源清单。纳入综述的10项研究中有9项报告了良好的结果。
综述中纳入的研究随访期相对较短，且所识别研究的多样性排除了进行荟萃分析的可能性。
研究结果表明，在儿科初级保健机构中进行干预是可行的，并且可以对临床实践和家庭结局产生积极影响。
