Sá Mariana, Pereira Paulo Almeida, Castro-Vale Ivone
Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Unidade de Saúde Familiar Famílias, Agrupamento de Centros de Saúde Entre Douro e Vouga I-Feira/Arouca, 4535-086 Lourosa, Portugal.
Healthcare (Basel). 2023 Sep 1;11(17):2450. doi: 10.3390/healthcare11172450.
Addressing trauma has been found to be important for primary care patients, as it can improve their health-related outcomes. We aimed to assess how Portuguese general practitioners' (GPs) past history of traumatic events (TEs) and adverse childhood experiences (ACEs) influence their clinical communication skills when addressing their patients' past history of adversities. An online survey was circulated by email to GPs' associations and through GPs' social media groups. A sample of 143 GPs participated in this study. GPs' exposure to ACEs and TEs was assessed using the Childhood Trauma Questionnaire-Short Form and the Life Events Checklist for the DSM-5. To evaluate clinical communication skills, we adapted the Self-confidence Scale and used the Jefferson Scale of Physician Empathy. GPs identified barriers to addressing trauma routinely, including a lack of time (86.7%) and a fear of causing further patient suffering (56.6%). GPs' exposure to TEs and ACEs was positively correlated with scores in some dimensions of self-confidence and empathy ( values varying from 0.170 to 0.247). GPs exposed to traumatic experiences felt more confident when addressing their patients' adversities and were more empathic when conducting therapeutic relationships. This study shows that GPs with a history of traumatic experiences are able to address their patients' adversities; however, they lack proper training and better patient care conditions, such as more time and more resources available for patient guidance.
研究发现,处理创伤对初级保健患者很重要,因为这可以改善他们与健康相关的结果。我们旨在评估葡萄牙全科医生(GPs)过去的创伤事件(TEs)和童年不良经历(ACEs)如何影响他们在询问患者过去的逆境经历时的临床沟通技巧。通过电子邮件向全科医生协会以及通过全科医生的社交媒体群组发放了一份在线调查问卷。143名全科医生参与了这项研究。使用儿童创伤问卷简表和《精神疾病诊断与统计手册》第5版生活事件清单评估全科医生接触ACEs和TEs的情况。为了评估临床沟通技巧,我们改编了自信量表并使用了杰斐逊医生同理心量表。全科医生指出了常规处理创伤的障碍,包括时间不足(86.7%)和担心给患者带来更多痛苦(56.6%)。全科医生接触TEs和ACEs与自信和同理心某些维度的得分呈正相关(相关值从0.170到0.247不等)。有创伤经历的全科医生在询问患者的逆境经历时感觉更自信,在建立治疗关系时更具同理心。这项研究表明,有创伤经历的全科医生能够处理患者的逆境经历;然而,他们缺乏适当的培训和更好的患者护理条件,比如缺乏更多时间和更多资源用于患者指导。