Green Bonnie L, Saunders Pamela A, Power Elizabeth, Dass-Brailsford Priscilla, Schelbert Kavitha Bhat, Giller Esther, Wissow Larry, Hurtado de Mendoza Alejandra, Mete Mihriye
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.
J Loss Trauma. 2016;21(2):147-159. doi: 10.1080/15325024.2015.1084854. Epub 2015 Sep 25.
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.
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。