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初级保健中的ACE调查:对北爱尔兰全科医生观点的定性探索

ACE Enquiry in Primary care: A Qualitative Exploration of the Perspective of General Practitioners in Northern Ireland.

作者信息

Smyth Rafael, McSherry Dominic

机构信息

School of Psychology, Ulster University, Coleraine, Northern Ireland.

Reader in Psychology, Ulster University, Coleraine, Northern Ireland.

出版信息

J Child Adolesc Trauma. 2024 Sep 28;18(1):57-70. doi: 10.1007/s40653-024-00660-3. eCollection 2025 Mar.

Abstract

This study sought to identify gaps in the current literature base by exploring the perspectives of General Practitioners (GPs) in Northern Ireland in relation to the significance, relevance, and feasibility of conducting a comprehensive inquiry into Adverse Childhood Experiences (ACEs) with patients. Semi-structured, in-depth interviews were conducted with 10 qualified GPs using Zoom Videoconferencing technology. Interviews were audio recorded and transcribed verbatim. Qualitative data was analysed using Theoretical Thematic Analysis (Braun & Clarke Qualitative Research in Psychology 3(2):77-101, 2006). Analysis revealed nine key superordinate themes. These themes encompassed various aspects such as the role of a GP, trauma-informed training, the advantages and barriers associated with conducting an ACE assessment, and the impact of childhood adversity on subsequent physical and mental health. This study provides valuable primary care professional insights that contribute to the existing evidence base. It highlights the importance of recognising, discussing, and screening for ACEs in primary care settings. Furthermore, this study explores a range of practical adjustments that could support the implementation of routine ACE enquiry within the primary healthcare system in Northern Ireland.

摘要

本研究旨在通过探究北爱尔兰全科医生(GP)对于与患者进行全面童年不良经历(ACEs)调查的重要性、相关性和可行性的看法,来找出当前文献基础中的空白。使用Zoom视频会议技术对10名合格的全科医生进行了半结构化深度访谈。访谈进行了录音并逐字转录。使用理论主题分析法(布劳恩和克拉克,《心理学定性研究》3(2):77 - 101,2006年)对定性数据进行了分析。分析揭示了九个关键的上位主题。这些主题涵盖了多个方面,如全科医生的角色、创伤知情培训、进行ACE评估的优势和障碍,以及童年逆境对后续身心健康的影响。本研究提供了有价值的初级保健专业见解,为现有证据基础做出了贡献。它强调了在初级保健环境中识别、讨论和筛查ACEs的重要性。此外,本研究探讨了一系列实际调整措施,这些措施可以支持在北爱尔兰初级医疗保健系统中实施常规ACE调查。

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