退伍军人愿意在初级保健中讨论枪支安全问题。
Veterans Are Agreeable to Discussions About Firearms Safety in Primary Care.
机构信息
From the Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, OR (SN, EKenyon, VE, AR, SKD); Division of Psychology, Oregon Health & Science University, Portland (EKenyon); Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR (KDC); National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR (KDC); Hearing Center of Excellence, Department of Defense, San Antonio, TX (KDC); Division of Hospital and Specialty Medicine, VA Portland Health Care System, Portland, OR (MSG); Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University, Portland (MSG); Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, NY (EKarras); Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (EKarras); Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, VHA, Aurora, CO. (JAS); Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VHA, Aurora, CO (JAS); Department of Psychiatry, Oregon Health & Science University, Portland (SKD).
出版信息
J Am Board Fam Med. 2021 Mar-Apr;34(2):338-345. doi: 10.3122/jabfm.2021.02.200261.
BACKGROUND
Discussing safe storage of firearms, including access, during times of crisis with veterans in primary care settings may enhance suicide prevention efforts. However, veteran attitudes toward such discussions are not well understood. The goal of this study is to understand the perspectives of veterans on discussing firearms storage safety with staff during primary care visits.
METHODS
Individual semistructured interviews with veterans were conducted by telephone, qualitatively coded, and analyzed for themes. The sample was composed of veterans (n = 27) who had positive depression or post-traumatic stress disorder screens and who received care from Veterans Health Administration primary care team members trained to discuss firearms storage safety with patients.
RESULTS
Citing the urgent need to prevent veteran suicide, most veterans felt discussing firearms safety was acceptable and needed, even if discussions felt uncomfortable or they had concerns. Veterans identified the need for providers to be transparent in their purposes for asking about firearms and to respect veterans' unique relationships with firearms.
DISCUSSION
Conducting firearms safety discussions in a primary care setting with veterans who are at elevated risk for suicide is acceptable to veterans when a respectful, veteran-centered, and transparent approach is used.
背景
在初级保健环境中与退伍军人讨论枪支安全储存问题，包括在危机时期的枪支获取问题，这可能有助于加强预防自杀工作。然而，退伍军人对这类讨论的态度尚不清楚。本研究的目的是了解退伍军人对在初级保健就诊期间与工作人员讨论枪支储存安全问题的看法。
方法
通过电话对有积极抑郁或创伤后应激障碍筛查结果的退伍军人进行个人半结构化访谈，对访谈内容进行定性编码和主题分析。该样本由退伍军人（n=27）组成，他们接受了接受过培训以与患者讨论枪支安全储存问题的退伍军人健康管理局初级保健团队成员的治疗。
结果
大多数退伍军人认为，为了防止退伍军人自杀，讨论枪支安全问题是可以接受和必要的，即使讨论感到不舒服或他们有顾虑。退伍军人认为，提供者需要透明地说明询问枪支的目的，并尊重退伍军人与枪支的独特关系。
讨论
在初级保健环境中与有自杀风险的退伍军人进行枪支安全讨论是可以接受的，只要使用尊重、以退伍军人为中心和透明的方法。
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