Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey
Abstract Background Adverse Childhood Experiences (ACEs) are common and associated with many illnesses. Most physicians do not routinely screen for ACEs. We aimed to determine if screening is related to knowledge or medical specialty, and to assess perceived barriers. Methods Physicians in Ontario,...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-020-05124-6 |
| _version_ | 1818410448765059072 |
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| author | Robert G. Maunder Jonathan J. Hunter David W. Tannenbaum Thao Lan Le Christine Lay |
| author_facet | Robert G. Maunder Jonathan J. Hunter David W. Tannenbaum Thao Lan Le Christine Lay |
| author_sort | Robert G. Maunder |
| collection | DOAJ |
| description | Abstract Background Adverse Childhood Experiences (ACEs) are common and associated with many illnesses. Most physicians do not routinely screen for ACEs. We aimed to determine if screening is related to knowledge or medical specialty, and to assess perceived barriers. Methods Physicians in Ontario, Canada completed an online survey in 2018–2019. Data were analyzed in 2019. Results Participants were 89 family physicians, 46 psychiatrists and 48 other specialists. Participants screened for ACEs “never or not usually” (N = 58, 31.7%), “when indicated” (N = 67, 36.6%), “routinely” (N = 50, 27.3%) or “other” (N = 5, 2.7%). Screening was strongly associated with specialty (Chi2 = 181.0, p < .001). The modal responses were: family physicians - “when indicated” (66.3%), psychiatrists - “routinely” (91.3%), and other specialists - “never or not usually” (77.1%). Screening was not related to knowledge of prevalence of ACEs, or of the link between ACEs and mental health, but was significantly associated with knowing that ACEs are associated with physical health. Knowing that ACEs are linked to stroke, ischemic heart disease, COPD, and diabetes predicted greater screening (Chi2 15.0–17.7, each p ≤ .001). The most prevalent perceived barriers to screening were lack of mental health resources (59.0%), lack of time (59.0%), concern about causing distress (49.7%) and lack of confidence (43.7%). Conclusions Enhancing knowledge about ACEs’ negative influence on physical illness may increase screening. Efforts to promote screening should address concerns that screening is time-consuming and will increase referrals to mental health resources. Education should focus on increasing confidence with screening and with managing patient distress. |
| first_indexed | 2024-12-14T10:15:41Z |
| format | Article |
| id | doaj.art-f6b2dd3051254267ae013867292d0347 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-14T10:15:41Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-f6b2dd3051254267ae013867292d03472022-12-21T23:06:52ZengBMCBMC Health Services Research1472-69632020-04-012011510.1186/s12913-020-05124-6Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a surveyRobert G. Maunder0Jonathan J. Hunter1David W. Tannenbaum2Thao Lan Le3Christine Lay4Department of Psychiatry, Sinai Health System and University of TorontoDepartment of Psychiatry, Sinai Health System and University of TorontoDepartment of Family Medicine, Sinai Health System and University of TorontoDepartment of Psychiatry, Sinai Health System and University of TorontoDepartment of Medicine, Women’s College Hospital and University of TorontoAbstract Background Adverse Childhood Experiences (ACEs) are common and associated with many illnesses. Most physicians do not routinely screen for ACEs. We aimed to determine if screening is related to knowledge or medical specialty, and to assess perceived barriers. Methods Physicians in Ontario, Canada completed an online survey in 2018–2019. Data were analyzed in 2019. Results Participants were 89 family physicians, 46 psychiatrists and 48 other specialists. Participants screened for ACEs “never or not usually” (N = 58, 31.7%), “when indicated” (N = 67, 36.6%), “routinely” (N = 50, 27.3%) or “other” (N = 5, 2.7%). Screening was strongly associated with specialty (Chi2 = 181.0, p < .001). The modal responses were: family physicians - “when indicated” (66.3%), psychiatrists - “routinely” (91.3%), and other specialists - “never or not usually” (77.1%). Screening was not related to knowledge of prevalence of ACEs, or of the link between ACEs and mental health, but was significantly associated with knowing that ACEs are associated with physical health. Knowing that ACEs are linked to stroke, ischemic heart disease, COPD, and diabetes predicted greater screening (Chi2 15.0–17.7, each p ≤ .001). The most prevalent perceived barriers to screening were lack of mental health resources (59.0%), lack of time (59.0%), concern about causing distress (49.7%) and lack of confidence (43.7%). Conclusions Enhancing knowledge about ACEs’ negative influence on physical illness may increase screening. Efforts to promote screening should address concerns that screening is time-consuming and will increase referrals to mental health resources. Education should focus on increasing confidence with screening and with managing patient distress.http://link.springer.com/article/10.1186/s12913-020-05124-6Childhood adversityChild abuseMedical history takingPrevention |
| spellingShingle | Robert G. Maunder Jonathan J. Hunter David W. Tannenbaum Thao Lan Le Christine Lay Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey BMC Health Services Research Childhood adversity Child abuse Medical history taking Prevention |
| title | Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey |
| title_full | Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey |
| title_fullStr | Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey |
| title_full_unstemmed | Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey |
| title_short | Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey |
| title_sort | physicians knowledge and practices regarding screening adult patients for adverse childhood experiences a survey |
| topic | Childhood adversity Child abuse Medical history taking Prevention |
| url | http://link.springer.com/article/10.1186/s12913-020-05124-6 |
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