压力性及潜在创伤性事件与医疗保健利用：特罗姆瑟7项调查
Stressful and potentially traumatic events and healthcare utilization: the 7 Tromsø survey.
作者信息
Thimm Jens C, Rognmo Kamilla, Skre Ingunn, Wang Catharina E A
机构信息
Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway.
Centre for Crisis Psychology, University of Bergen, Bergen, Norway.
出版信息
BMC Health Serv Res. 2025 Mar 27;25(1):455. doi: 10.1186/s12913-025-12604-0.
BACKGROUND
Stressful and potentially traumatic life events (SLEs/PTEs) can have a profound negative impact on the individual's mental and physical wellbeing and health. Consequently, an association of SLEs/PTEs with increased healthcare utilization has been found. However, most studies have been conducted in selected samples (e.g., veterans), and there is a paucity of studies in the general population. The present study examined the associations between SLEs/PTEs and the utilization of healthcare services in the general population using data from the seventh survey of the Tromsø study (Tromsø7).
METHODS
The sample comprised 20,069 participants aged 40 years and above (52.5% female, mean age 57.3 years, SD = 11.4 years) who completed measures of SLE/PTE exposure in childhood/adolescence and adulthood (including a question about mental preoccupation with SLEs/PTEs), utilization of a variety of healthcare services (general practitioner, medical specialist, hospital, emergency room, mental health services, physiotherapist, and complementary and alternative medicine provider) in the previous year, and self-reported feeling of being anxious or depressed.
RESULTS
The results showed that SLE/PTE exposure is associated with an increased use of all healthcare services, especially mental health professionals. Exposure to physical and emotional neglect in childhood/adolescence, violence, and sexual abuse showed the strongest associations with the utilization of mental health services. The strength of the associations with health service utilization increased with the number of SLEs/PTEs. Finally, mental preoccupation with the event(s) moderated the associations between SLE/PTE exposure and the utilization of healthcare services but not self-reported feeling of being anxious or depressed.
CONCLUSION
It is concluded that the prevention of SLEs/PTEs and screening for SLE/PTE exposure in healthcare services to provide trauma-informed care should be a prioritized public health focus.
背景
压力性及潜在创伤性生活事件（SLEs/PTEs）会对个体的身心健康产生深远的负面影响。因此，已发现SLEs/PTEs与医疗保健利用率增加之间存在关联。然而，大多数研究是在特定样本（如退伍军人）中进行的，而针对普通人群的研究较少。本研究利用特罗姆瑟研究第七次调查（Tromsø7）的数据，探讨了普通人群中SLEs/PTEs与医疗服务利用之间的关联。
方法
样本包括20,069名40岁及以上的参与者（52.5%为女性，平均年龄57.3岁，标准差=11.4岁），他们完成了童年/青少年期和成年期SLE/PTE暴露的测量（包括一个关于对SLEs/PTEs的心理关注的问题）、前一年各种医疗服务（全科医生、医学专家、医院、急诊室、心理健康服务、物理治疗师以及补充和替代医学提供者）的利用情况，以及自我报告的焦虑或抑郁情绪。
结果
结果显示，SLE/PTE暴露与所有医疗服务的使用增加有关，尤其是心理健康专业服务。童年/青少年期遭受身体和情感忽视、暴力和性虐待与心理健康服务的利用之间的关联最为强烈。与医疗服务利用的关联强度随着SLEs/PTEs的数量增加而增强。最后，对事件的心理关注调节了SLE/PTE暴露与医疗服务利用之间的关联，但未调节自我报告的焦虑或抑郁情绪。
结论
得出的结论是，预防SLEs/PTEs以及在医疗服务中筛查SLE/PTE暴露以提供创伤知情护理应成为公共卫生的优先重点。
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