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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Primary care utilization and detection of emotional distress after adolescent traumatic injury: identifying an unmet need.
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Primary care utilization and detection of emotional distress after adolescent traumatic injury: identifying an unmet need.

机译：青少年创伤后的初级保健利用和情绪困扰的检测：确定未满足的需求。

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OBJECTIVE: Few investigations have assessed the primary care detection of adolescent posttraumatic emotional distress after an injury. We aimed to determine (1) the level of attachment to primary care providers (PCPs) and school providers among this group of high-risk adolescents, (2) the emotional status of this population postinjury, (3) continuity of care between trauma center and community care, and (4) PCPs' detection of emotional problems in adolescents after an injury. METHODS: This was a prospective cohort study of traumatically injured adolescents aged 12 to 18 who were admitted to a level I regional trauma center. Adolescents were screened for posttraumatic stress symptoms, depressive symptoms, and alcohol use on the surgical ward and 4 to 6 months postinjury. PCPs were contacted by telephone 4 to 6 months postinjury to assess follow-up care and the detection of emotional distress. RESULTS: In the surgical ward, 39.4% of the adolescent patients or their parents reported no identifiable sourceof regular medical care. Only 24.3% of the patients had visited a PCP during the 4 to 6 months after injury. At 4 to 6 months postinjury, 30% of the adolescents were experiencing high posttraumatic stress symptom levels, 11% were experiencing high depressive symptom levels, and 17% had high levels of alcohol use. PCPs did not detect any new emotional distress or problem drinking during postinjury office visits. CONCLUSIONS: Injured adolescents represent a high-risk pediatric population, a substantial number of whom develop mental health problems postinjury. Furthermore, almost 40% of adolescents in our study reported no source of primary care. These results suggest that referrals from trauma centers to PCPs are necessary and that an increase in awareness of and screening for adolescent emotional distress postinjury during follow-up appointments and at school should be routine components of postinjury care.
机译：目的：很少有研究评估创伤后青少年创伤后情绪困扰的初级保健检测。我们的目标是确定（1）在这组高风险青少年中对初级保健提供者（PCPs）和学校提供者的依恋程度;（2）该人群受伤后的情绪状况;（3）创伤中心之间照护的连续性和社区护理，以及（4）PCP在受伤后发现青少年的情绪问题。方法：这是一项前瞻性队列研究，研究对象是12到18岁遭受创伤的青少年，他们进入了I级区域创伤中心。对青少年进行了创伤后应激症状，抑郁症状的检查，以及在外科病房和受伤后4至6个月内饮酒的情况。在受伤后4至6个月通过电话与五氯苯酚接触，以评估后续护理和情绪困扰的检测。结果：在外科病房中，有39.4％的青少年患者或其父母报告没有可确定的常规医疗来源。在受伤后的4到6个月内，只有24.3％的患者去过PCP。受伤后4至6个月，有30％的青少年经历高创伤后应激症状水平，11％经历高抑郁症状水平，而17％的青少年酗酒。 PCP在受伤后的办公室就诊中没有发现任何新的情绪困扰或饮酒问题。结论：受伤的青少年是高危儿科人群，其中很大一部分在受伤后出现精神健康问题。此外，在我们的研究中，几乎40％的青少年报告没有初级保健来源。这些结果表明，从创伤中心转诊到PCP是必要的，并且在随访期间和在学校期间提高对青少年情绪困扰后伤害的认识和筛查应作为伤害后护理的常规组成部分。

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