Brooks E Marshall, Tong Sebastian T, Krist Alex H, Kuzel Anton J
From Virginia Commonwealth University (EMB, AHK, AJK); University of Washington (STT).
J Am Board Fam Med. 2022 Aug 25. doi: 10.3122/jabfm.2022.AP.210283.
Gun violence is a growing public health epidemic that disproportionately affects underserved and minority communities. Our study sought to document patient experiences of community gun violence as a theme that emerged in the context of interviews exploring community-level factors influencing patients' engagement in primary care within the context of a larger study on cardiovascular health.
We completed semistructured qualitative interviews of individuals with uncontrolled hypertension recruited from primary care practices serving underserved communities in metro Richmond, Virginia that were participating in a larger study on improving cardiovascular health.
Of 19 individuals interviewed, 11 discussed without prompting the negative effects of gun violence in their community. Themes that emerged included both the acute and chronic traumatic experience, the physiologic and cognitive effects of gun violence and the negative effects on ability to manage heart health.
The effects of gun violence on not only cardiovascular health but also all aspects of health emerged unprompted in qualitative interviews about community level factors influencing management of cardiovascular health. Given the widespread negative effects of experiencing gun violence on health, family physicians could play an important role in identifying and managing the effects of gun violence. Future studies on how primary care clinicians can address gun violence in the caring for their patients comprehensively are needed.
枪支暴力是一种日益严重的公共卫生流行病,对服务不足和少数族裔社区的影响尤为严重。在一项关于心血管健康的大型研究中,我们的研究旨在记录社区枪支暴力患者的经历,这是在探讨影响患者参与初级保健的社区层面因素的访谈中出现的一个主题。
我们对从弗吉尼亚州里士满市服务不足社区的初级保健机构招募的未控制高血压患者进行了半结构化定性访谈,这些机构正在参与一项关于改善心血管健康的大型研究。
在接受访谈的19人中,11人在未被提示的情况下讨论了社区枪支暴力的负面影响。出现的主题包括急性和慢性创伤经历、枪支暴力的生理和认知影响以及对心脏健康管理能力的负面影响。
在关于影响心血管健康管理的社区层面因素的定性访谈中,枪支暴力对心血管健康乃至健康各个方面的影响在未被提示的情况下就显现出来了。鉴于经历枪支暴力对健康有广泛的负面影响,家庭医生在识别和管理枪支暴力的影响方面可以发挥重要作用。未来需要研究初级保健临床医生如何在全面照顾患者时应对枪支暴力问题。