Pediatric Primary Care Provider Perspectives on Universal Suicide Screening.

IF 3 Q1 PRIMARY HEALTH CARE Journal of Primary Care and Community Health Pub Date : 2024-01-01 DOI:10.1177/21501319241271321
Katie Plax, Edan Leshem, Sherry Dodd, Ruoyun Wang, Shannon Rook, Lauren Ericson, Andrew Solsrud
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Abstract

Introduction: Given the increase in youth mental health concerns, the American Academy of Pediatrics (AAP) recommends universal suicide screening for ages 12 and older, with positive screens followed by a brief suicide risk assessment. However, it is unclear how pediatric clinicians incorporate this recommendation into practice. Therefore, the objective of this qualitative study was to identify pediatric clinicians' current practice, attitudes, and barriers to implement the updated universal suicide screening recommendation in primary care.

Methods: Community-based pediatric primary care providers (PCPs) in the St. Louis Metropolitan area who by self-report provide mental health care for patients participated. Participants completed a 30-minute semi-structured interview with invitations extended through an electronic listserv in a local Pediatric PCP Learning Collaborative. Interviews were transcribed and analyzed using consensual deductive and inductive approaches until data saturation.

Results: Eighteen PCPs participated in the interviews. Interviews described themes related to acceptability of the recommendations, PCPs' current screening practices, and perceived barriers for implementing the recommendations. Overall, PCPs agreed with, but expressed hesitancy about, the recommendation. Frequently mentioned barriers to suicide screening included time, training, and inadequate access to resources for follow-up care for at-risk patients. Yet, PCPs were optimistic they could learn with support and were interested in working in this subject area through quality improvement interventions.

Conclusions: PCPs agree with the AAP recommendation about suicide screening but need support to implement into practice. Specifically, PCPs need time sensitive strategies, resources, training, and practice change support to assist these efforts.

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儿科初级保健提供者对普及自杀筛查的看法。
导言:鉴于青少年心理健康问题的增加,美国儿科学会(AAP)建议对 12 岁及以上的青少年进行普遍自杀筛查,筛查结果呈阳性的青少年应接受简短的自杀风险评估。然而,目前还不清楚儿科临床医生是如何将这一建议付诸实践的。因此,本定性研究旨在确定儿科临床医生目前的做法、态度以及在初级保健中实施最新的普遍自杀筛查建议的障碍:方法:圣路易斯大都会地区的社区儿科初级保健医生(PCPs)参加了这项研究,他们自我报告说为患者提供心理健康护理。参与者通过当地儿科初级保健医生学习合作组织的电子列表服务器发出邀请,完成了 30 分钟的半结构式访谈。访谈内容采用共识演绎法和归纳法进行誊写和分析,直至数据饱和:18 名初级保健医生参加了访谈。访谈描述了与建议的可接受性、初级保健医生目前的筛查实践以及实施建议的已知障碍有关的主题。总体而言,初级保健医生同意该建议,但表示犹豫不决。他们经常提到的自杀筛查障碍包括时间、培训以及为高危患者提供的后续护理资源不足。然而,初级保健医生们乐观地认为,他们可以在支持下学习,并有兴趣通过质量改进干预措施在这一主题领域开展工作:结论:初级保健医生同意美国医学会关于自杀筛查的建议,但需要支持才能将其付诸实践。具体而言,初级保健医生需要时间敏感的策略、资源、培训和实践变革支持来协助这些工作。
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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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