Patient Preferences for Discussing Childhood Trauma in Primary Care.
Exposure to traumatic events is common in primary care patients, yet health care professionals may be hesitant to assess and address the impact of childhood trauma in their patients.



To assess patient preferences for discussing traumatic experiences and posttraumatic stress disorder (PTSD) with clinicians in underserved, predominantly Latino primary care patients.



Cross-sectional study.



We evaluated patients with a questionnaire assessing comfort to discuss trauma exposure and symptoms using the Adverse Childhood Experiences (ACE) Study questionnaire and the Primary Care-PTSD screen. The questionnaire also assessed patients' confidence in their clinicians' ability to help with trauma-related issues. Surveys were collected at an integrated medical and behavioral health care clinic.



Of 178 adult patients asked, 152 (83%) agreed to participate. Among participants, 37% screened positive for PTSD, 42% reported 4 or more ACEs, and 26% had elevated scores on both measures. Primary Care-PTSD and ACE scores were strongly positively correlated (r = 0.57, p < 0.001). Most patients agreed they were comfortable being asked about trauma directly or through screening questionnaires and did not oppose the inclusion of trauma-related information in their medical record. In addition, most patients perceived their clinician as comfortable asking questions about childhood trauma and able to address trauma-related problems.



Screening is acceptable to most primary care patients regardless of trauma exposure or positive PTSD screening. Findings may aid primary care clinicians to consider screening regularly for ACEs and PTSD to better serve the health care needs of trauma-exposed patients.
Doctoral Graduate from the Betty Irene Moore School of Nursing at the University of California, Davis. ellengoldstein8@gmail.com.
Ellen
E
Goldstein
Family Physician at OLE Health, an Associate Medical Director of County Campus, the Medical Director of Napa County Alcohol and Drug Services, and a Volunteer Clinical Instructor at the University of California, Davis School of Medicine. nathale@olehealth.org.
Ninad
N
Athale
Associate Professor at the Department of Psychiatry and Behavioral Sciences at the University of California, Davis. afsciolla@ucdavis.edu.
Andrés F
AF
Sciolla
Professor of Nursing Science from the Betty Irene Moore School of Nursing at the University of California, Davis. scatz@ucdavis.edu.
Sheryl L
SL
Catz
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D030881:Disclosure; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D057240:Patient Preference; D010817:Physician-Patient Relations; D011320:Primary Health Care; D000067073:Psychological Trauma; D013313:Stress Disorders, Post-Traumatic; D011795:Surveys and Questionnaires; D055815:Young Adult