Department of General Practice and Primary Care, University of Melbourne, Melbourne, VIC, Australia.
Department of General Practice, Monash University, Melbourne, VIC, Australia.
BMC Prim Care. 2024 Sep 12;25(1):336. doi: 10.1186/s12875-024-02573-4.
Exposure to domestic and family violence is a pervasive form of complex trauma and a major global public health problem. At the frontline of the health system, primary healthcare practitioners are uniquely placed to support individuals with experiences of trauma, yet their views on trauma-informed primary care are not well understood. This systematic review of qualitative literature sought to explore primary healthcare practitioners' perspectives on trauma-informed primary care.
Eight databases were searched up to July 2023. Studies were included if they consisted of empirical qualitative data, were conducted in general practice or equivalent generalist primary healthcare settings, and included the perspectives of primary healthcare practitioners where they could be distinguished from other participants in the analysis. Thematic synthesis was used for analysis.
13 papers met inclusion criteria, representing primary care settings from the United States, Canada, Australia, and Norway. Three key themes were developed: Changing the paradigm, Building trust, and Navigating the emotional load. Findings shed light on how primary healthcare practitioners perceive and strive to practise trauma-informed primary healthcare and the challenges of navigating complex, trauma-related work in the primary care environment.
This review supports the need for recognition of the value of primary care in supporting patients with histories of trauma and violence, the development of interventions to mitigate the emotional load worn by primary healthcare practitioners, and further work to develop a deep and consistent understanding of what trauma-informed primary care encompasses.
家庭暴力和家庭问题是一种普遍存在的复杂创伤形式，也是一个重大的全球公共卫生问题。在卫生系统的前线，初级保健医生是支持有创伤经历的个人的最佳人选，但他们对以创伤知情为基础的初级保健的看法还没有得到很好的理解。本系统综述的目的是探索初级保健医生对以创伤知情为基础的初级保健的看法。
截至 2023 年 7 月，在 8 个数据库中进行了搜索。如果研究包含经验性的定性数据，在普通科或同等的全科初级保健环境中进行，并且包括初级保健医生的观点，可以将其与分析中的其他参与者区分开来，则将其纳入研究。采用主题综合法进行分析。
符合纳入标准的有 13 篇论文，代表了来自美国、加拿大、澳大利亚和挪威的初级保健机构。确定了三个关键主题：改变范式、建立信任和应对情绪负担。研究结果揭示了初级保健医生如何看待和努力实践以创伤知情为基础的初级保健，以及在初级保健环境中应对复杂的创伤相关工作的挑战。
本综述支持承认初级保健在支持有创伤和暴力史的患者方面的价值，需要制定干预措施来减轻初级保健医生的情绪负担，并进一步努力深入和一致地理解以创伤知情为基础的初级保健所涵盖的内容。
