Patient Preferences for Discussing Childhood Trauma in Primary Care

Overview

Journal Perm J

Specialties General Medicine
Health Services

Date 2017 Mar 24

PMID 28333604

Citations 27

Authors

Ellen Goldstein

Ninad Athale

Andres F Sciolla

Sheryl L Catz

Affiliations

Soon will be listed here.

Abstract

Context: Exposure to traumatic events is common in primary care patients, yet health care professionals may be hesitant to assess and address the impact of childhood trauma in their patients.

Objective: To assess patient preferences for discussing traumatic experiences and posttraumatic stress disorder (PTSD) with clinicians in underserved, predominantly Latino primary care patients.

Design: Cross-sectional study.

Main Outcome Measure: We evaluated patients with a questionnaire assessing comfort to discuss trauma exposure and symptoms using the Adverse Childhood Experiences (ACE) Study questionnaire and the Primary Care-PTSD screen. The questionnaire also assessed patients' confidence in their clinicians' ability to help with trauma-related issues. Surveys were collected at an integrated medical and behavioral health care clinic.

Results: Of 178 adult patients asked, 152 (83%) agreed to participate. Among participants, 37% screened positive for PTSD, 42% reported 4 or more ACEs, and 26% had elevated scores on both measures. Primary Care-PTSD and ACE scores were strongly positively correlated (r = 0.57, p < 0.001). Most patients agreed they were comfortable being asked about trauma directly or through screening questionnaires and did not oppose the inclusion of trauma-related information in their medical record. In addition, most patients perceived their clinician as comfortable asking questions about childhood trauma and able to address trauma-related problems.

Conclusion: Screening is acceptable to most primary care patients regardless of trauma exposure or positive PTSD screening. Findings may aid primary care clinicians to consider screening regularly for ACEs and PTSD to better serve the health care needs of trauma-exposed patients.

Citing Articles

Resident Physicians' Perceptions of Trauma Informed Care: Findings from a Small-scale Descriptive Study.

Nutting R, Nilsen K, Engle R, Wells K, Scoville H Kans J Med. 2023; 16:264-267.

PMID: 37954885 PMC: 10635682. DOI: 10.17161/kjm.vol16.21000.

Use of Metaphor as an Explanation Tool in Adverse Childhood Experiences Simulation Training.

Ha M, Rowe A, Hendrix K, Anwar S, Mang K, Wen F Perm J. 2023; 27(4):72-81.

PMID: 37876251 PMC: 10723095. DOI: 10.7812/TPP/22.159.

Des expériences négatives de l'enfance à la santé relationnelle précoce : les conséquences pour la pratique clinique.

Williams R Paediatr Child Health. 2023; 28(6):377-393.

PMID: 37744761 PMC: 10517240. DOI: 10.1093/pch/pxad026.

From ACEs to early relational health: Implications for clinical practice.

Williams R Paediatr Child Health. 2023; 28(6):377-393.

PMID: 37744756 PMC: 10517248. DOI: 10.1093/pch/pxad025.

General Practitioners' Own Traumatic Experiences and Their Skills in Addressing Patients' Past History of Adversities: A Cross-Sectional Study in Portugal.

Sa M, Pereira P, Castro-Vale I Healthcare (Basel). 2023; 11(17).

PMID: 37685484 PMC: 10487406. DOI: 10.3390/healthcare11172450.

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