Provider Perspectives on Addressing Firearm Safety with Older Adults in Primary Care.

IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY
Clinical Gerontologist Pub Date : 2024-07-01 Epub Date: 2023-10-04 DOI:10.1080/07317115.2023.2264291
Rachel Ross, Laura C Prater, Allison Cole, Ayah Mustafa, Kiet Pham, Monica Zigman Suchsland, Amy Gallagher, Ali Rowhani-Rahbar, Elizabeth A Phelan
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引用次数: 0

Abstract

Objectives: Chronic conditions, including mild cognitive impairment and depression, place older adults at high risk of firearm suicide. Approximately 40% of older adults have access to a firearm, and many do not store their firearms safely. However, firearm counseling occurs infrequently in clinical settings. Using by the Ottawa Decision Support Framework (ODSF) to conceptualize the decisional support needed by patients and their providers to facilitate firearm counseling, we explore provider perspectives on desired resources for addressing firearm safety with older adult patients.

Methods: From March - August 2022, we conducted 21 semi-structured interviews with primary care providers caring for older adults. We report deductive concepts as well as emergent themes.

Results: Major themes were identified from the three components of the ODSF; decisional needs, decision support and decisional outcomes. Themes included: provider self-efficacy to conduct firearm counseling, clinical workflow considerations, stories for change, patient diagnosis implications, and caregiver involvement.

Conclusions: There is a need for decision aids in the clinical setting that facilitate firearm counseling and promotes shared decision-making about firearm storage.

Clinical implications: Implementing a decision aid in the clinical setting can improve provider self-efficacy to conduct firearm counseling and help reduce risk factors associated with firearm-related harm among older adults.

在初级保健中解决老年人火器安全问题的提供者观点。
目的:慢性疾病,包括轻度认知障碍和抑郁症,使老年人面临持枪自杀的高风险。大约40%的老年人可以获得枪支,许多人没有安全地储存枪支。然而,枪支咨询在临床环境中很少发生。通过渥太华决策支持框架(ODSF)来概念化患者及其提供者为促进枪支咨询所需的决策支持,我们探讨了提供者对解决老年患者枪支安全问题所需资源的看法。方法:从2022年3月至8月,我们对照顾老年人的初级保健提供者进行了21次半结构化访谈。我们报告演绎概念以及涌现主题。结果:从ODSF的三个组成部分中确定了主要主题;决策需求、决策支持和决策结果。主题包括:提供者进行枪支咨询的自我效能感、临床工作流程考虑、变革故事、患者诊断影响和护理人员参与。结论:在临床环境中需要决策辅助工具,以促进枪支咨询并促进关于枪支储存的共同决策。临床意义:在临床环境中实施决策辅助可以提高提供者进行枪支咨询的自我效能,并有助于减少老年人中与枪支相关伤害相关的风险因素。
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来源期刊
Clinical Gerontologist
Clinical Gerontologist GERIATRICS & GERONTOLOGY-PSYCHIATRY
CiteScore
6.20
自引率
25.00%
发文量
90
审稿时长
>12 weeks
期刊介绍: Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including: -adjustments to changing roles- issues related to diversity and aging- family caregiving- spirituality- cognitive and psychosocial assessment- depression, anxiety, and PTSD- Alzheimer’s disease and other neurocognitive disorders- long term care- behavioral medicine in aging- rehabilitation and education for older adults. Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.
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