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本文引用的文献

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Trauma-informed medical care: CME communication training for primary care providers.创伤知情医疗护理:针对初级保健提供者的继续医学教育沟通培训。
Fam Med. 2015 Jan;47(1):7-14.
2
Interventions for providers to promote a patient-centred approach in clinical consultations.为医疗服务提供者提供的干预措施,以促进临床会诊中以患者为中心的方法。
Cochrane Database Syst Rev. 2012 Dec 12;12(12):CD003267. doi: 10.1002/14651858.CD003267.pub2.
3
Attachment and health care relationships in low-income women with trauma histories: a qualitative study.创伤史低收入女性的依附关系和医护关系:一项定性研究。
J Trauma Dissociation. 2012;13(2):190-208. doi: 10.1080/15299732.2012.642761.
4
Physician and patient communication training in primary care: effects on participation and satisfaction.初级保健中的医患沟通培训:对参与度和满意度的影响。
Health Psychol. 2008 Sep;27(5):513-22. doi: 10.1037/0278-6133.27.5.513.
5
The impact of trauma exposure and post-traumatic stress disorder on healthcare utilization among primary care patients.创伤暴露和创伤后应激障碍对初级保健患者医疗服务利用的影响。
Med Care. 2008 Apr;46(4):388-93. doi: 10.1097/MLR.0b013e31815dc5d2.
6
PTSD in urban primary care: high prevalence and low physician recognition.城市基层医疗中的创伤后应激障碍:高患病率与医生的低识别率
J Gen Intern Med. 2007 Jun;22(6):719-26. doi: 10.1007/s11606-007-0161-0. Epub 2007 Mar 10.
7
Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection.基层医疗中的焦虑症:患病率、损害、共病情况及检测
Ann Intern Med. 2007 Mar 6;146(5):317-25. doi: 10.7326/0003-4819-146-5-200703060-00004.
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Evaluating the cultural validity of the stressful life events screening questionnaire.评估应激性生活事件筛查问卷的文化效度。
Violence Against Women. 2006 Dec;12(12):1191-213. doi: 10.1177/1077801206294534.
9
Family medicine attributes related to satisfaction, health and costs.与满意度、健康和成本相关的家庭医学属性。
Fam Pract. 2006 Jun;23(3):308-16. doi: 10.1093/fampra/cmi112. Epub 2006 Feb 3.
10
Posttraumatic stress disorder in primary care: prevalence and relationships with physical symptoms and medical utilization.基层医疗中的创伤后应激障碍:患病率及其与躯体症状和医疗利用的关系。
Gen Hosp Psychiatry. 2005 Nov-Dec;27(6):392-9. doi: 10.1016/j.genhosppsych.2005.06.004.

创伤知情医疗护理:患者对初级保健提供者沟通培训的反应

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training.

作者信息

Green Bonnie L, Saunders Pamela A, Power Elizabeth, Dass-Brailsford Priscilla, Schelbert Kavitha Bhat, Giller Esther, Wissow Larry, Hurtado de Mendoza Alejandra, Mete Mihriye

机构信息

Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA.

Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA ; Department of Neurology, Georgetown University Medical School, Washington, DC, USA.

出版信息

J Loss Trauma. 2016;21(2):147-159. doi: 10.1080/15325024.2015.1084854. Epub 2015 Sep 25.

DOI:10.1080/15325024.2015.1084854
PMID:27721673
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5051697/
Abstract

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma's effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents ( = 17; 2 sites) or community physicians ( = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.

摘要

创伤暴露可预测精神障碍和健康结果;然而,针对初级保健提供者进行的关于创伤影响以及如何更好地与创伤幸存者互动的培训却很少。本研究将一种基于理论的与创伤幸存者合作的方法“冒险建立联系”改编成一门6小时的继续医学教育课程“创伤知情医疗护理(TI-Med)”,以评估其可行性和初步疗效。我们将四个初级保健机构随机分为培训组或等待名单组;等待名单组的初级保健医生在重新评估后接受培训。初级保健提供者(PCP)为家庭医学住院医师(n = 17;2个机构)或社区医生(n = 13;2个机构)。此处报告的结果包括对该研究中PCP诊治的400名实际患者的一项调查。患者大多为少数族裔,在其提供者接受培训之前或之后完成调查。在涵盖合作关系问题的量表上,患者在培训后对PCP的评分显著更高。细分结果显示,有创伤或创伤后应激症状的患者合作关系得分较低。未来的研究需要纳入更具体的与创伤相关的结果。尽管如此,这种培训是向初级保健医生传授创伤知情沟通技巧的一种有前景的初步方法。