Physician-reported practice of managing childhood posttraumatic stress in pediatric primary care

Gen Hosp Psychiatry. 2008 Nov-Dec;30(6):536-45. doi: 10.1016/j.genhosppsych.2008.07.008. Epub 2008 Sep 5.

Abstract

Objective: This study investigated pediatrician-reported practices in identifying, assessing, and treating traumatic exposure and posttraumatic stress disorder (PTSD) in children.

Method: Focus groups guided the development of a survey that was mailed to primary care pediatricians in Massachusetts in 2005. Descriptive statistics and multivariate analyses were used to describe clinical practices and perceived barriers to care.

Results: A 60% (N=597) survey response-rate was obtained. On average, pediatricians reported that less than 8% of patients had psychological problems that may be related to traumatic exposure. Only 18% of pediatricians agreed that they had adequate knowledge of childhood PTSD. About 15% of pediatricians reported frequently learning about traumatic event(s) from direct inquiry in the past year. Only 10% of pediatricians reported frequent assessment and treatment of posttraumatic stress symptoms. Most pediatricians (72%) agreed that greater collaborations with mental health providers would improve pediatric assessment of PTSD. Finally, having received PTSD-specific training and believing that pediatricians should identify and manage PTSD were each significantly associated with learning about a traumatic event from direct inquiry.

Conclusion(s): Providing PTSD-specific training and changing pediatricians' attitudes about childhood PTSD may be useful first steps in improving care for children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Child
  • Cooperative Behavior
  • Culture
  • Female
  • Health Surveys
  • Humans
  • Inservice Training
  • Male
  • Mass Screening
  • Massachusetts
  • Middle Aged
  • Pediatrics / education
  • Primary Health Care
  • Referral and Consultation
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy
  • Surveys and Questionnaires