外科医生对临床实践中枪支安全咨询的看法：一项横断面调查。

Surgeon views on firearm safety counseling in clinical practice: A cross-sectional survey.

作者信息

Kirkendoll Shelbie D, Silver Casey M, Stey Anne M, Nathens Avery B, Jackson Kathryn, Campbell Brendan T

机构信息

From the American College of Surgeons (S.D.K.); Department of Surgery (S.D.K., C.M.S., A.M.S.), Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Surgery (A.B.N.), Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada; Department of Medical Social Sciences (K.J.), Northwestern University, Chicago, Illinois; and Department of Pediatric Surgery (B.T.C.), Connecticut Children's Medical Center, Hartford, Connecticut.

出版信息

J Trauma Acute Care Surg. 2024 Mar 1;96(3):455-460. doi: 10.1097/TA.0000000000004197. Epub 2023 Nov 7.

DOI:10.1097/TA.0000000000004197

PMID:37934626

Abstract

BACKGROUND

Firearms are commonplace in the United States, and one proposed strategy to decrease risk of firearm injury is to have physicians counsel their patients about safe firearm ownership. Current rates of firearm safety counseling by surgeons who care for injured people are unknown.

METHODS

This study used an anonymous cross-sectional survey derived from previously published survey instruments and was piloted (n = 13) at the annual meeting of the American Association for the Surgery of Trauma (2022). The finalized survey was distributed using a quick response code during two sessions at the 2022 American College of Surgeons Clinical Congress. Eligible participants included the surgeons and surgical trainees who attended these sessions.

RESULTS

One hundred fourteen individuals completed the survey (20% response rate), and a majority were male (n = 71 [62.3%]), attending surgeons (n = 108 [94.7%]), and specialized in acute care surgery (n = 72 [63.2%]). Few participants (n = 43 [37.7%]) reported counseling patients on firearm safety as part of their routine clinical practice; however, the majority (n = 102 [89.5%]) believed that surgeons should provide firearm safety counseling. Counseling rates did not vary significantly by age, sex, surgical specialty, or region of practice, but attitudes toward counseling did differ by firearm safety counseling practices ( p = 0.03) and region of practice (0.04). Noted barriers to counseling included lack of time (n = 47 [41.2%]), perceived lack of training (n = 43 [37.7%]), and lack of firearm knowledge/experience (n = 36 [31.6%]).

CONCLUSION

Most surgeon respondents did not provide firearm safety counseling to their patients despite the fact the majority believed they should. This suggests that counseling interventions that do not solely rely on surgeons for implementation could increase the number of patients who receive firearm safety guidance during clinical encounters.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.

摘要

背景

枪支在美国很常见，一种降低枪支伤害风险的提议策略是让医生就枪支安全拥有问题向患者提供咨询。目前，治疗受伤患者的外科医生进行枪支安全咨询的比例尚不清楚。

方法

本研究使用了一份源自先前发表的调查工具的匿名横断面调查问卷，并在美国创伤外科学会年会（2022年）上进行了预试验（n = 13）。最终调查问卷在2022年美国外科医师学会临床大会的两场会议期间通过二维码进行分发。符合条件的参与者包括参加这些会议的外科医生和外科实习生。

结果

114人完成了调查（回复率为20%），大多数为男性（n = 71 [62.3%]）、主治外科医生（n = 108 [94.7%]），且专长于急性 care 手术（n = 72 [63.2%]）。很少有参与者（n = 43 [37.7%]）报告在其日常临床实践中就枪支安全问题向患者提供咨询；然而，大多数（n = 102 [89.5%]）认为外科医生应该提供枪支安全咨询。咨询率在年龄、性别、外科专科或执业地区方面没有显著差异，但对咨询的态度在枪支安全咨询实践（p = 0.03）和执业地区（0.04）方面确实有所不同。指出的咨询障碍包括缺乏时间（n = 47 [41.2%]）、感觉缺乏培训（n = 43 [37.7%]）以及缺乏枪支知识/经验（n = 36 [31.6%]）。