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童年不良经历对基层医疗服务提供者中创伤知情护理的影响:一项横断面研究。

The Influence of Adverse Childhood Experiences on Trauma Informed Care Among Primary Care Providers: A Cross-Sectional Study.

作者信息

Gardner Kayla, Ivins Benjamin, Mathis Peters Trinity, Novilla Len, Crandall Ali, Hanson Carl L

机构信息

Brigham Young University, Provo, UT, USA.

出版信息

Inquiry. 2025 Jan-Dec;62:469580251365460. doi: 10.1177/00469580251365460. Epub 2025 Sep 11.

Abstract

Adverse childhood experiences (ACEs) are linked to lasting health and socioeconomic challenges; however, less is known about how primary care providers' own trauma histories impact their provision of trauma-informed care (TIC). This cross-sectional survey study assessed the relationship between primary care providers' personal trauma history (ACE scores), personal reaction to trauma (burnout, compassion fatigue, and vicarious victimization), and TIC practice. A total of 167 primary care providers were recruited between March 2024 and August 2024 and completed a 38-item online survey. Measures included the Trauma Informed Care-Provider Assessment Tool (TIC-PAT), the Professional Quality of Life Scale (ProQLS), the ACEs Study Questionnaire, and demographics. Descriptive statistics and multiple linear regression analysis was conducted. Respondents were an average of 59.73 years old, white (88.89%) and medical doctors (90.48%). Average ACE score of respondents was 1.4 (SD = 1.47). Analysis revealed that providers with higher ACEs scores were significantly more likely to implement TIC ( = 0.11,  = .02). However, no significant association was found between personal reaction to trauma and TIC provision. Findings suggest that primary care providers with personal trauma histories may be more attuned to the effects of trauma, leading to greater TIC implementation. The study highlights the importance of TIC training for all providers-particularly for those with lower ACE scores-while also recognizing that providers with higher ACE scores may benefit from training to manage personal trauma and enhance their clinical practice.

摘要

童年不良经历(ACEs)与持久的健康和社会经济挑战相关;然而,对于初级保健提供者自身的创伤史如何影响他们提供创伤知情护理(TIC),我们了解得较少。这项横断面调查研究评估了初级保健提供者的个人创伤史(ACE评分)、对创伤的个人反应(职业倦怠、同情疲劳和替代性受害)与TIC实践之间的关系。在2024年3月至2024年8月期间,共招募了167名初级保健提供者,他们完成了一份38项的在线调查。测量工具包括创伤知情护理提供者评估工具(TIC-PAT)、职业生活质量量表(ProQLS)、ACEs研究问卷和人口统计学信息。进行了描述性统计和多元线性回归分析。受访者平均年龄为59.73岁,白人(88.89%),医生(90.48%)。受访者的平均ACE评分为1.4(标准差=1.47)。分析表明,ACE评分较高的提供者实施TIC的可能性显著更高(β=0.11,p=0.02)。然而,未发现对创伤的个人反应与提供TIC之间存在显著关联。研究结果表明,有个人创伤史的初级保健提供者可能更能意识到创伤的影响,从而导致更多地实施TIC。该研究强调了对所有提供者进行TIC培训的重要性——特别是对于那些ACE评分较低的提供者——同时也认识到ACE评分较高的提供者可能会从管理个人创伤和加强临床实践的培训中受益。

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