Department of Psychiatry and Department of Ob/Gyn, Children's Hospital Colorado, University of Colorado School of Medicine.
Department of Psychiatry, Children's Hospital Colorado, University of Colorado School of Medicine.
Psychol Serv. 2019 Feb;16(1):67-74. doi: 10.1037/ser0000315. Epub 2018 Nov 26.
Adolescent mothers experience higher rates of trauma and abuse, as well as increased risks for mental health disorders, compared to adolescent girls who are not mothers, making them a particularly vulnerable population and contributing to them feeling less supported by or allied with their medical provider. Women with a history of childhood abuse face increased rates of obstetric complications; their infants are at increased risk for low birthweight, developmental and intellectual delays, and behavioral problems. Trauma-informed care has become widespread in mental health settings; however, this model has not been as commonly applied to other settings, such as patient-centered medical homes (PCMHs). The Colorado Adolescent Maternity Program (CAMP) is an obstetric and pediatric medical home for pregnant and parenting adolescent girls through age 22 and their children located within Children's Hospital Colorado. With the integration of behavioral health into CAMP, and given the prevalence of trauma histories among adolescent mothers reported in the literature, programmatic and operational changes to clinical care were made using the Substance Abuse and Mental Health Services Administration's six key principles of a trauma-informed approach. Data showed that nearly 30% of participants reported a history of trauma. Following the inclusion of trauma-informed principles, patients had significantly higher rates of attendance at prenatal appointments (p < .001) and significantly lower rates of low birthweight babies (p = .02). Future programmatic changes and long-term assessment outcomes of this trauma-informed approach in a PCMH are also discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
青少年母亲比非母亲的青少年女孩经历更高的创伤和虐待率，以及更高的心理健康障碍风险，这使她们成为一个特别脆弱的群体，并导致她们感到自己得到的医疗服务提供者的支持或联盟较少。有儿童期虐待史的妇女面临更高的产科并发症发生率；她们的婴儿出生体重低、发育和智力迟缓以及行为问题的风险增加。创伤知情护理在精神卫生环境中已经得到广泛应用；然而，这种模式并没有像在其他环境中那样常见，例如以患者为中心的医疗之家（PCMH）。科罗拉多青少年产妇计划（CAMP）是一个为怀孕和有子女的青少年女孩提供的产科和儿科医疗之家，年龄在 22 岁以下，她们的孩子位于科罗拉多儿童医院内。随着行为健康融入 CAMP，并且考虑到文献中报道的青少年母亲创伤史的普遍存在，临床护理的方案和操作发生了变化，使用了物质滥用和心理健康服务管理局的创伤知情方法的六个关键原则。数据显示，近 30%的参与者报告有创伤史。在纳入创伤知情原则后，患者产前预约的出席率显著提高（p<.001），低出生体重婴儿的比例显著降低（p=.02）。还讨论了这种在 PCMH 中的创伤知情方法的未来方案变化和长期评估结果。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
