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一个机会之窗:美国儿童期不良经历与与医疗服务提供者单独相处的时间

A window of opportunity: Adverse childhood experiences and time alone with a provider in the United States.

作者信息

Ng Amanda E, Tkach Nicholas, Alcalá Héctor E

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, United States of America.

Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, United States of America.

出版信息

Prev Med. 2023 Oct;175:107675. doi: 10.1016/j.ypmed.2023.107675. Epub 2023 Aug 24.

Abstract

BACKGROUND

To date, there is limited literature on the relationship between Adverse Childhood Experiences (ACEs) and the quality of health care provider encounters. This is key, as people with a history of ACEs have a greater burden of illness.

METHODS

This study uses data from the 2020-2021 National Survey of Children's Health to examine relationships between ACEs and (1) spending less than ten minutes with a health care provider, and (2) spending time alone with a health care provider.

RESULTS

In general, our results suggested most ACEs were associated with higher odds of a provider spending <10 min with a child during their last preventative care visit, while ACEs were inconsistently related to spending time alone with a provider. Each additional ACE was found to be associated with higher odds of both outcomes.

CONCLUSIONS

This work emphasizes the importance of ACEs screening in a health care setting and may set the groundwork for future research investigating mechanisms within these associations. Given the established link between health care quality and patient-provider trust, and health outcomes, intervention work is needed to develop healthcare practices that may encourage the length and quality of health care provider visits.

摘要

背景

迄今为止,关于儿童期不良经历(ACEs)与医疗服务提供者诊疗质量之间关系的文献有限。这一点至关重要,因为有ACEs病史的人疾病负担更重。

方法

本研究使用2020 - 2021年全国儿童健康调查的数据,来检验ACEs与以下两方面的关系:(1)与医疗服务提供者相处时间少于十分钟,以及(2)与医疗服务提供者单独相处的时间。

结果

总体而言,我们的结果表明,大多数ACEs与医疗服务提供者在上次预防性诊疗期间与儿童相处时间少于10分钟的较高几率相关,而ACEs与与医疗服务提供者单独相处时间的关系并不一致。发现每增加一种ACE,这两种结果出现的几率都更高。

结论

这项工作强调了在医疗环境中进行ACEs筛查的重要性,并可能为未来研究这些关联中的机制奠定基础。鉴于医疗质量与医患信任以及健康结果之间已确立的联系,需要开展干预工作,以制定可能有助于延长医疗服务提供者诊疗时间并提高诊疗质量的医疗实践。

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