Patient Preferences for Discussing Childhood Trauma in Primary Care
Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
The Permanente Journal
Abstract
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.
-To assess patient preferences for discussing traumatic
experiences and posttraumatic stress disorder (PTSD)
with clinicians in underserved, predominantly Latino primary
care patients.
Cross-sectional study.
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.
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
Description
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Article
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Keywords
child abuse, screening, primary care setting, PTSD
Citation
Goldstein, E., Athale, N., Sciolla, A. F., & Catz, S. L. (2017). Patient Preferences for Discussing Childhood Trauma in Primary Care. The Permanente Journal, 21, 16–055.