Shoptaugh Amy, Morton Chloe, Dieu LaDon, Jones Jennifer, Lin Jefferson, Mirea Lucia, Samaddar Kristen
Center for Resiliency and Wellbeing, Phoenix Children's, 1919 E. Thomas Rd, Phoenix, AZ, 85016, USA.
Creighton University Health Sciences, Phoenix, AZ, USA.
BMC Health Serv Res. 2025 Apr 17;25(1):562. doi: 10.1186/s12913-025-12732-7.
Adverse childhood experiences (ACEs) are common and can negatively affect the physical, mental, emotional, and developmental health of a child acutely and for a lifetime. Trauma-informed care (TIC) in the pediatric medical home helps counteract these effects by fostering supportive relationships and building skills that promote resilience. As key figures in the medical home, pediatric clinicians must understand adverse childhood experiences (ACEs) and TIC principles to effectively recognize, assess and intervene early in cases of childhood adversity, which ultimately promotes long-term health and well-being.
Pediatric clinicians who attended a virtual symposium were surveyed before and after eight one-hour educational sessions on TIC topics. To assess their knowledge of fundamental TIC principles, they were asked about their familiarity with the ACE study, the affiliative response, and the strength-based approach in pediatrics. Participants rated each sessions' value using a 4-point Likert scale. In the post survey, they also shared how they would apply the knowledge gained clinically and suggestions to improve future education.
Seventy-five out of the 82 participants (91%) who were pediatric clinicians completed a pre survey and of those pediatric clinicians who completed the pre survey, 47 (63%) also completed the post-education survey. Prior to the educational sessions, 81% of participants were familiar with the ACE Study but only 37.1% were familiar with the affiliate response and only 50.6% with strength-based care approaches to pediatrics. Of those who completed the post survey, 95.7% rated the education as "Useful" or "Very useful." Statistically significant improvements were detected in scores relating to each of the three fundamental TIC principles: associations between childhood stressors and later life health and well-being (p = < 0.0001), familiarity with the affiliate response (p = < 0.0001), and familiarity with the concept of a strength-based approach to pediatrics (p = < 0.005). After the training sessions, a majority, 34/47 (72%), of participants stated they would apply concepts from the training in clinical care.
This study was able to demonstrate existing gaps in pediatric clinicians' knowledge of TIC, the usefulness of pediatric TIC education, and practical steps in providing TIC education for pediatric clinicians and healthcare providers.
儿童期不良经历（ACEs）很常见，会对儿童的身体、心理、情感和发育健康产生急性和终身的负面影响。儿科医疗之家的创伤知情护理（TIC）通过建立支持性的关系和培养促进恢复力的技能来抵消这些影响。作为医疗之家的关键人物，儿科临床医生必须了解儿童期不良经历（ACEs）和TIC原则，以便在儿童逆境案例中有效地识别、评估并尽早干预，最终促进长期健康和幸福。
参加虚拟研讨会的儿科临床医生在关于TIC主题的八次一小时教育课程前后接受了调查。为了评估他们对TIC基本原理的了解，询问了他们对ACE研究、亲和反应以及儿科中基于优势的方法的熟悉程度。参与者使用4点李克特量表对每次课程的价值进行评分。在课后调查中，他们还分享了将如何在临床中应用所学知识以及对改进未来教育的建议。
82名儿科临床医生参与者中有75名（91%）完成了课前调查，在完成课前调查的儿科临床医生中，有47名（63%）也完成了课后教育调查。在教育课程之前，81%的参与者熟悉ACE研究，但只有37.1%熟悉亲和反应，只有50.6%熟悉儿科中基于优势的护理方法。在完成课后调查的人中，95.7%将教育评为“有用”或“非常有用”。在与TIC的三个基本原理相关的分数上检测到了统计学上的显著改善：儿童期应激源与晚年健康和幸福之间的关联（p = < 0.0001）、对亲和反应的熟悉程度（p = < 0.0001）以及对儿科中基于优势方法概念的熟悉程度（p = < 0.005）。培训课程结束后，大多数参与者，即47人中的34人（72%）表示他们会在临床护理中应用培训中的概念。
本研究能够证明儿科临床医生在TIC知识方面存在的现有差距、儿科TIC教育的有用性以及为儿科临床医生和医疗保健提供者提供TIC教育的实际步骤。
