Collins Kimberly, Spice Carolin, Ingraham Bailey C, Al Achkar Morhaf
University of Washington, Seattle, WA.
PRiMER. 2021 Mar 18;5:13. doi: 10.22454/PRiMER.2021.971170. eCollection 2021.
Exposure to adverse childhood experiences (ACEs) has been associated with poor health in adulthood. Primary care providers can provide more appropriate medical care and intervene if they ask patients about ACEs. The purpose of this study is to determine existing knowledge and attitudes about ACEs among family medicine residents within the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region.
Researchers developed a nine-question survey to assess family medicine residents' knowledge and attitudes about ACEs, and their comfort level in addressing ACEs. The survey was distributed to 540 residents in 22 family medicine residency programs in the WWAMI region.
Most residents reported they had some (32%) or moderate (35%) knowledge of the ACEs study. However, 30% reported no knowledge of the ACEs study, and very few (3%) reported significant knowledge. Of 117 respondents reporting at least some prior knowledge of ACEs, 42% had first heard about ACEs during residency. The ACEs topics that respondents felt least comfortable addressing during a patient encounter were a patient's personal history of sexual abuse (75%) and witnessing physical abuse (47%). Most residents (84%) indicated that they would like to see ACEs integrated into their residency curriculum.
This study demonstrates a gap in residency training on the topic of ACEs in family medicine residencies within the WWAMI region. Residents are uncomfortable addressing ACEs with patients but are receptive to learning about this topic. More teaching about ACEs can increase residents' comfort level with addressing these topics in the primary care setting.
童年不良经历(ACEs)与成年后的健康状况不佳有关。如果初级保健提供者询问患者有关ACEs的情况,他们可以提供更合适的医疗护理并进行干预。本研究的目的是确定华盛顿、怀俄明、阿拉斯加、蒙大拿和爱达荷(WWAMI)地区家庭医学住院医师对ACEs的现有知识和态度。
研究人员设计了一份包含九个问题的调查问卷,以评估家庭医学住院医师对ACEs的知识、态度以及他们在处理ACEs时的舒适程度。该问卷被分发给WWAMI地区22个家庭医学住院医师培训项目中的540名住院医师。
大多数住院医师表示他们对ACEs研究有一些(32%)或中等程度(35%)的了解。然而,30%的人表示对ACEs研究一无所知,只有极少数人(3%)表示有深入了解。在117名报告至少对ACEs有一些先前了解的受访者中,42%是在住院医师培训期间首次听说ACEs。在患者就诊过程中,受访者最不愿意提及的ACEs主题是患者的性虐待个人史(75%)和目睹身体虐待(47%)。大多数住院医师(84%)表示他们希望看到ACEs被纳入住院医师培训课程。
本研究表明,WWAMI地区家庭医学住院医师培训在ACEs主题方面存在差距。住院医师在与患者讨论ACEs时感到不自在,但愿意学习这个主题。更多关于ACEs的教学可以提高住院医师在初级保健环境中处理这些主题的舒适度。