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公众对与患者讨论枪支问题是否合适的看法:一项全国性调查的结果。

Public Opinion Regarding Whether Speaking With Patients About Firearms Is Appropriate: Results of a National Survey.

机构信息

From the University of Colorado School of Medicine, Aurora, Colorado, and Injury Control Research Center, Harvard School of Public Health and Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts.

出版信息

Ann Intern Med. 2016 Oct 18;165(8):543-550. doi: 10.7326/M16-0739. Epub 2016 Jul 26.

Abstract

BACKGROUND

Health care providers have been encouraged to discuss firearms with patients; whether patients view these discussions as appropriate is unclear.

OBJECTIVE

To estimate, in a national sample, the perceived appropriateness of provider discussions about firearms.

DESIGN

Probability-based online survey conducted in April 2015. Analyses used survey weights to generate nationally representative estimates.

SETTING

U.S. adults.

PARTICIPANTS

3914 English-speaking adults (55% participation rate).

MEASUREMENTS

Participants were asked, "In general, would you think it is never, sometimes, usually, or always appropriate for physicians and other health professionals to talk to their patients about firearms?"

RESULTS

A majority (66% [95% CI, 63% to 69%]) of participants said that it is at least sometimes appropriate for providers to talk to patients about firearms. Specifically, 23% (CI, 20% to 25%) said that provider discussions about firearms were always appropriate, 14% (CI, 11% to 16%) said that they were usually appropriate, and 30% (CI, 27% to 33%) thought they were sometimes appropriate; 34% (CI, 31% to 37%) felt that such discussions were never appropriate. Views varied by firearm ownership: 54% (CI, 52% to 57%) of gun owners said that provider discussions are at least sometimes appropriate, compared with 67% (CI, 62% to 71%) of nonowners living with an owner and 70% (CI, 66% to 74%) of nonowners not living with an owner. Firearm owners who were more likely to think that firearm discussions are at least sometimes appropriate included those with children at home (62% [CI, 57% to 67%]), those who thought that having a gun at home increases suicide risk (75% [CI, 67% to 83%), and those who thought that provider discussions of seat belts are at least sometimes appropriate (73% [CI, 70% to 75%]).

LIMITATIONS

The provider discussion question did not specify clinical context.

CONCLUSION

Two thirds of non-firearm owners and over one half of firearm owners in the United States believe that health care provider discussions about firearms are at least sometimes appropriate. The observed heterogeneity underscores the need to better understand assumptions that may underlie these views, particularly among firearm owners.

PRIMARY FUNDING SOURCE

Fund for a Safer Future and Joyce Foundation.

摘要

背景

医疗服务提供者一直被鼓励与患者讨论枪支问题;但目前尚不清楚患者是否认为这些讨论是合适的。

目的

在全国样本中评估患者对提供者讨论枪支问题的看法。

设计

2015 年 4 月进行的基于概率的在线调查。分析使用调查权重生成具有全国代表性的估计值。

地点

美国成年人。

参与者

3914 名讲英语的成年人(参与率为 55%)。

测量方法

参与者被问及“一般来说,医生和其他健康专业人员与患者谈论枪支问题,您认为这是从不、有时、通常还是总是合适的?”

结果

大多数(66%[95%置信区间,63%至 69%])参与者认为,提供者与患者谈论枪支问题至少在某些情况下是合适的。具体而言,23%(置信区间,20%至 25%)的参与者认为提供者讨论枪支问题总是合适的,14%(置信区间,11%至 16%)的参与者认为通常合适,30%(置信区间,27%至 33%)的参与者认为有时合适;34%(置信区间,31%至 37%)的参与者认为这种讨论从不合适。观点因枪支拥有情况而异:54%(置信区间,52%至 57%)的枪支拥有者认为提供者讨论至少在某些情况下是合适的,而非枪支拥有者中,与枪支拥有者同住的人占 67%(置信区间,62%至 71%),不住在一起的人占 70%(置信区间,66%至 74%)。认为枪支讨论至少在某些情况下合适的枪支拥有者包括家中有孩子的人(62%[置信区间,57%至 67%])、认为家中有枪会增加自杀风险的人(75%[置信区间,67%至 83%])和认为提供者讨论安全带至少在某些情况下合适的人(73%[置信区间,70%至 75%])。

局限性

提供者讨论问题未具体说明临床背景。

结论

美国超过三分之二的非枪支拥有者和超过一半的枪支拥有者认为,医疗保健提供者讨论枪支问题至少在某些情况下是合适的。观察到的异质性突出表明,需要更好地了解这些观点可能存在的假设,特别是在枪支拥有者中。

主要资金来源

更安全的未来基金和乔伊斯基金会。

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