Barriers in the care of patients who have experienced a traumatic event: the perspective of general practice.
BACKGROUND
Previous research has indicated that GPs encounter barriers in the care of patients who have experienced a traumatic event.


OBJECTIVE
The aims of the present study were to map barriers GPs encounter in the care of patients who experience a traumatic event and solutions for these barriers, and to estimate the influence of GP characteristics on the number of barriers experienced.


METHODS
Telephone interviews were conducted among a sample of 500 Dutch GPs stratified by sex. Topics covered barriers in the care of victims of: accidents, incest in the past, ongoing physical or sexual abuse of adults, and ongoing physical or sexual abuse of children.


RESULTS
The response rate was 44%. GPs are regularly confronted with patients who have experienced a traumatic event. GPs experience 10% barriers in care of patients who have difficulties getting over an accident, 13% in the care of incest victims, 16% in the care of adults who are physically or sexually abused, and 20% in the care of physically or sexually abused children. Most of the GPs recently updated their knowledge of care of victims of traumatic events, but still the majority feel in need of additional expert training.


CONCLUSIONS
GPs experience the greatest number of barriers in the care of children who are abused. GP characteristics were not related to the number of barriers. However, seeing more victims was related to fewer barriers. To facilitate GP care of victims of traumatic events, GP training and continuing medical education should focus especially on skills education regarding the detection and initial treatment of traumatic events of ongoing physical or sexual abuse.
Department of General Practice, ExTra, Research Institute for Extramural and Transmural Care, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
M
M
van den Akker
S S
SS
Mol
J F
JF
Metsemakers
G J
GJ
Dinant
J A
JA
Knottnerus
D000059:Accidents; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D002983:Clinical Competence; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007179:Incest; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010821:Physicians, Family; D012017:Referral and Consultation; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires