Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Health Promot Pract. 2024 Jan;25(1):29-32. doi: 10.1177/15248399231164909. Epub 2023 Mar 30.
The American Academy of Pediatrics recommends that children and adolescents be universally screened for access to firearms and exposure to violence. The purpose of this study was to characterize how often pediatric residents at one institution document screening for firearm access and violence risk factors and provide risk reduction counseling in the primary care setting. A retrospective chart review was conducted at two primary care clinics in Baltimore, Maryland, for patient ages 10 to 25 years who were seen by resident physicians for well care between October 2019 and December 2020. We reviewed 169 patients' charts meeting the inclusion criteria. Forty (24%) patients had a documented history of exposure to violence or history of suicidal ideation. Based on resident documentation, one (<1%) patient was screened for firearm access or exposure to firearm violence and 10 (6%) were provided risk reduction counseling or any type of firearm safety counseling. Pediatric resident physicians at our institution rarely screen for firearm access or provide violence prevention counseling in the primary care setting. Targeted interventions and quality improvement projects are needed to address screening barriers and design novel interventions to overcome these barriers.
美国儿科学会建议对儿童和青少年进行普遍的枪支获取和暴力暴露筛查。本研究的目的是描述在马里兰州巴尔的摩的两家初级保健诊所中，一家机构的儿科住院医师在初级保健环境中记录枪支获取和暴力风险因素筛查以及提供减少风险咨询的频率。对 2019 年 10 月至 2020 年 12 月期间接受住院医师看诊的年龄在 10 至 25 岁之间的患者进行了回顾性图表审查。我们共审查了符合纳入标准的 169 名患者的图表。40 名（24%）患者有暴力暴露或自杀意念的病史。根据住院医师的记录，只有 1 名（<1%）患者接受了枪支获取或枪支暴力暴露筛查，10 名（6%）患者接受了减少风险咨询或任何类型的枪支安全咨询。我们机构的儿科住院医师很少在初级保健环境中对枪支获取或提供预防暴力咨询进行筛查。需要采取有针对性的干预措施和质量改进项目来解决筛查障碍，并设计新的干预措施来克服这些障碍。
