儿童不良经历在初级保健中的训练,查和反应的影响:系统性审查
Ryan K McBain1,2, Jonathan S Levin2, Samantha Matthews3
1Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA.
EClinicalMedicine
|December 18, 2023
概括
在初级保健中对不良童年经历 (ACE) 的培训,查和反应的证据有限. 虽然培训提高了提供者的信心,查提高了吸收率,但需要更多的研究,特别是对于成年人群.
科学领域:
- 公共卫生 公共卫生
- 儿科 儿科 儿科
- 家庭医学 家庭医学 家庭医学
背景情况:
- 童年不良经历 (ACE) 对长期健康有重大影响.
- 初级保健提供者 (PCP) 处于有利地位,能够减轻ACE的影响.
- 在初级保健机构内对ACE干预措施的研究有限.
研究的目的:
- 系统地审查ACE培训,查和初级保健中的反应的影响.
- 评估ACE干预的提供者和患者相关结果.
- 确定初级保健中ACEs的证据基础中的差距.
主要方法:
- 从1998年到2023年对四个数据库 (PubMed,科学网络,APA PsycInfo,CINAHL) 的系统审查.
- 将同行评审的初级研究纳入初级保健机构.
- 提取提供者和患者的结果,包括知识,信心,查行为,满意度和健康结果.
主要成果:
- 58项研究符合纳入标准;大多数专注于儿科患者和查干预措施.
- 证据的强度通常很低,特别是在成人研究中,由于研究设计和结果措施.
- 培训干预表明改善提供者信心的适度证据;查干预表明增加查吸收和患者满意度的适度证据.
结论:
- 初级保健是解决ACE的战略设置,但目前对干预措施的证据很少.
- 需要进行进一步的研究,以加强初级保健中ACE干预措施的证据基础,特别是在成年人群中.
- 专注于提供者培训和查的干预措施有望改善结果.
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