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成人初级保健机构中的童年不良经历(ACEs)筛查:一项系统综述

Adverse Childhood Experiences (ACEs) Screening in Primary Care Settings for Adults: A Systematic Review.

作者信息

Küçükardalı-Cansever Betül, Lamson Angela, Sira Natalia, Bridgland Stephanie Ann, Eagan Sheena, Roberts Erin

机构信息

Department of Human Development and Family Science, College of Health and Human Performance, East Carolina University, Mailstop 505 Greenville, Greenville, NC 27858 USA.

Department of Psychology, East Carolina University, Greenville, NC USA.

出版信息

J Child Adolesc Trauma. 2025 Feb 12;18(2):377-393. doi: 10.1007/s40653-025-00691-4. eCollection 2025 Jun.

Abstract

UNLABELLED

Substantial evidence links ACE scores with adult health complications, emphasizing the significance of enhanced detection, interpretation, and management of ACEs in primary care settings for adults. This systematic review aims to explore existing ACE screening and post-screening practices for adult patients in primary care settings worldwide via a thorough systematic review, including a search of PubMed, PsycINFO, and CINAHL databases. Out of an initial 883 potential articles from two independent reviewers, 53 articles met the inclusion and exclusion criteria. Most studies were conducted in the US (71.7%). Globally, 83% of the ACE screening studies indicated that ACES were screened specifically for research purposes, while the remaining 17% covered quality improvement, trauma-informed care interventions, and routine screenings in healthcare settings. This review delves into various intricacies of ACEs screening, the professional roles involved in the screening process, the location where the screening was conducted, prior training on ACEs for the screening implementers, and subsequent actions like interventions, referrals, and resource allocation. Despite growing awareness of the long-term effects of ACEs, a gap exists between ACEs research and related clinical practices in primary care. Additionally, there is no consensus on how to utilize ACEs screening in primary care and which ACE scores necessitate indicated interventions. Implications focus on the collaborative health use of ACEs screenings in primary care.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40653-025-00691-4.

摘要

未标注

大量证据将不良童年经历(ACE)评分与成人健康并发症联系起来,强调了在成人初级保健环境中加强对ACE的检测、解读和管理的重要性。本系统评价旨在通过全面的系统评价,探索全球初级保健环境中成年患者现有的ACE筛查及筛查后实践,包括检索PubMed、PsycINFO和CINAHL数据库。在两名独立评审员最初筛选出的883篇潜在文章中,有53篇符合纳入和排除标准。大多数研究在美国进行(71.7%)。在全球范围内,83%的ACE筛查研究表明,ACE是专门为研究目的而进行筛查的,其余17%涵盖质量改进、创伤知情护理干预以及医疗保健环境中的常规筛查。本综述深入探讨了ACE筛查的各种复杂情况、筛查过程中涉及的专业角色、筛查进行的地点、筛查实施者之前接受的ACE培训,以及后续行动,如干预、转诊和资源分配。尽管人们对ACE的长期影响的认识不断提高,但在初级保健中,ACE研究与相关临床实践之间仍存在差距。此外,对于如何在初级保健中利用ACE筛查以及哪些ACE评分需要进行指定干预,尚无共识。其影响集中在初级保健中ACE筛查的协同健康应用。

补充信息

在线版本包含可在10.1007/s40653-025-00691-4获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5827/12129883/0b691640147a/40653_2025_691_Fig1_HTML.jpg

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