Titus Stephen J, Huo Lucy, Godwin Joseph, Shah Samiksha, Cox Thomas, Ogola Gerald O, Ahmed Kashif Waqiee
Department of Family Medicine, Baylor University Medical Center, Dallas, Texas.
MD Family Clinic, Dallas, Texas.
Proc (Bayl Univ Med Cent). 2021 Nov 19;35(4):405-409. doi: 10.1080/08998280.2021.2004532. eCollection 2022.
A significant public health burden exists related to firearm-related injuries in the United States. Primary care physicians (PCPs) find themselves on the frontline to address it. This study aimed to determine if PCPs feel prepared and responsible for providing firearm safety counseling. Data were gathered via a direct 23-question survey of family medicine, internal medicine, and pediatric physicians and residents in North and Central Texas between May 2019 and January 2020. The survey was delivered to 518 outpatient providers, with a 24% response rate. Associations were assessed by chi-square/Fisher's exact test. A total of 62% agreed that preventable firearm death is an important health issue and PCPs can have a positive effect; 10% felt their residency provided or provides opportunities to learn about firearm safety and how to counsel patients; 55% agreed that a standardized tool to question and counsel patients on firearm safety such as a template in the electronic health record would be useful; and 68% stated they would use a standardized template in their practice if proven to reduce firearm-related injuries. Physicians who had received training in residency felt their knowledge was adequate to be able to provide meaningful counseling to patients ( < 0.001). In conclusion, PCPs are pivotal in addressing firearm safety. A formal curriculum across primary care specialties' graduate education programs should be developed to improve physicians' competency in addressing firearm safety. Further investigation into standardized tools that could be implemented into an electronic health record may help bridge the gap from awareness to implementation of interventions.
在美国,与枪支相关的伤害造成了重大的公共卫生负担。基层医疗医生(PCP)发现自己处于应对这一问题的前沿。本研究旨在确定基层医疗医生是否觉得自己有准备且有责任提供枪支安全咨询。2019年5月至2020年1月期间,通过对北德克萨斯州和中德克萨斯州的家庭医学、内科以及儿科医生和住院医师进行直接的23个问题的调查收集数据。该调查发送给了518名门诊医疗服务提供者,回复率为24%。通过卡方检验/费舍尔精确检验评估相关性。共有62%的人同意可预防的枪支死亡是一个重要的健康问题,基层医疗医生可以产生积极影响;10%的人觉得他们在住院实习期间有或现在有机会学习枪支安全知识以及如何为患者提供咨询;55%的人同意,像电子健康记录中的模板这样用于询问和为患者提供枪支安全咨询的标准化工具会很有用;68%的人表示,如果经证实能减少与枪支相关的伤害,他们会在自己的医疗实践中使用标准化模板。在住院实习期间接受过培训的医生觉得自己的知识足以能够为患者提供有意义的咨询(<0.001)。总之,基层医疗医生在解决枪支安全问题方面至关重要。应制定涵盖所有基层医疗专业研究生教育项目的正式课程,以提高医生解决枪支安全问题的能力。对可纳入电子健康记录的标准化工具进行进一步研究,可能有助于弥合从意识到实施干预措施之间的差距。