Patients’ Perceptions of the Role of Physicians in Questioning and Educating in Firearms Safety: Post-FOPA Repeal Era

Boge, Laurie; Santos, Carlos Pereira dos; Burkholder, Justin D.; Koschel, Bradley R; Cubeddu, Luigi X.; Farcy, David A.

doi:10.14423/smj.0000000000000915

Cited by 5 publications

(5 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our main finding that veterans believe such discussions are acceptable under some circumstances is consistent with other works showing that veterans, 16 other patient groups, 20,30,31 and clinicians 16,32 are willing to discuss FSS, especially when discussions are conducted in a culturally sensitive, nonjudgmental manner [33][34][35] and patients are made aware of the discussion's direct relevance to the patient's safety and wellbeing. 36 This includes veterans who receive VHA mental health care: in one survey of veterans receiving depression treatment within VHA, 93% endorsed one or more health systems interventions aimed at reducing veterans' access to firearms during high-risk periods.…”

Section: Discussionsupporting

confidence: 88%

Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives

et al. 2021

View full text Add to dashboard Cite

BACKGROUND: Two-thirds of veteran suicides are attributable to firearm injury. Although half of veterans who die by suicide are seen in primary care settings in the month prior to death, little is known about how to promote firearm safety within primary care. OBJECTIVE: Describe veterans' perspectives on discussing firearms storage safety (FSS) during primary care visits, and identify key strategies for primary care teams to use in discussing FSS with veterans at elevated risk for suicide. DESIGN: Qualitative analysis of transcripts and notes from four veteran focus groups and from individual semi-structured interviews with six veterans. PARTICIPANTS: Altogether, 68 veterans participated. Three of the groups were associated with one Veterans Health Administration facility. Groups were diverse in age, service era, and gender. APPROACH: The goals of the focus groups and interviews were to assess acceptance of FSS discussions during primary care visits, identify facilitators and barriers to conducting FSS discussions, and identify strategies for primary care teams to use to effectively conduct FSS discussions. Transcripts and meeting notes were analyzed using a grounded theory approach. KEY RESULTS: There was general acceptance of having FSS discussions in primary care. Yet, most veterans did not support direct questioning about firearm ownership, which may trigger fears of having firearms taken away or limit access to firearms. Participants recommended primary care teams provide rationale for FSS discussions and be prepared to provide information on legal consequences of disclosing firearm ownership. Strategies suggested for primary care staff also included using a personalized, caring, and conversational approach rather than highly scripted or checklist approach, engaging veterans in a non-judgmental manner, and conveying respect for veterans' knowledge of firearms.CONCLUSIONS: Discussing FSS with veterans in primary care settings is a promising upstream approach that can complement other suicide prevention efforts, but must be conducted in a veteran-centric manner.

show abstract

Section: Discussionsupporting

confidence: 88%

Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 34 , 35 Two studies (4%) looked into developing screening tools to predict future risk of firearm violence, 22 , 31 and five (11%) assessed patient and provider attitudes toward asking about firearm access and safety in the ED. 19 , 20 , 45 , 47 , 50 Forty-two percent of publications focused on pediatric ED patients. A plurality of interventional studies (43%) focused on lethal means counseling.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

View full text Add to dashboard Cite

Introduction: Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed. Methods: We conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., “homelessness,” “housing instability”) based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed “similar publications” tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator. Results: Our search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010–2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area – included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization. Conclusion: Social emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.

show abstract

“…[12][13][14] Contrary to the myth that patients resent being counseled on firearm safety by their doctors, the literature shows that patients are receptive to discussing firearm injury prevention with physicians, as long as counseling is delivered in a respectful manner. 15,16 While physicians who own firearms may be more likely to discuss firearm injury prevention with patients than those that don't, 17 in general, few physicians raise the subject with patients. This is true despite physicians in general believing they have the right to discuss firearm safety, and medical leadership groups and patients concurring and encouraging such discussions.…”

Section: Introductionmentioning

confidence: 99%

Emergency Physician Survey on Firearm Injury Prevention: Where Can We Improve?

Farcy¹,

Doria²,

Moreno‐Walton³

et al. 2021

W J Emerg Med

View full text Add to dashboard Cite

Introduction: Firearm injury and death is increasingly prevalent in the United States. Emergency physicians (EP) may have a unique role in firearm injury prevention.The aim of this study was to describe EPs' beliefs, attitudes, practices, and barriers to identifying risk of and counseling on firearm injury prevention with patients. A secondary aim was assessment of perceived personal vulnerability to firearm injury while working in the emergency department (ED).Methods: We conducted a cross-sectional survey of a national convenience sample of EPs, using questions adapted from the American College of Surgeons' Committee on Trauma 2017 survey of surgeons. Descriptive statistics and chi-square tests were calculated as appropriate.Results: A total of 1901 surveys were completed by EPs from across the United States. Among respondents, 42.9% had a firearm at home, and 56.0% had received firearm safety training. Although 51.4% of physicians in our sample were comfortable discussing firearm access with their high-risk patients, more than 70% agreed or strongly agreed that they wanted training on procedures to follow when they identify that a patient is at high risk of firearm injury. Respondents reported a variety of current practices regarding screening, counseling, and resource use for patients at high risk of firearm injury; the highest awareness and self-reported screening and counseling on firearm safety was with patients with suicidal ideation. Although 92.3% of EPs reported concerns about personal safety associated with firearms in the ED, 48.1% reported that there was either no protocol for dealing with a firearm in the ED, or if there was a protocol, they were not aware of it. Differences in demographics, knowledge, attitudes, and behavior were observed between respondents with a firearm in the home, and those without a firearm in the home.Conclusions: Among respondents to this national survey of a convenience sample of EPs, approximately 40% had a firearm at home. The majority reported wanting increased education and training to identify and counsel ED patients at high risk for firearm injury. Improved guidance on personal safety regarding firearms in the ED is also needed. [

show abstract

Patients’ Perceptions of the Role of Physicians in Questioning and Educating in Firearms Safety: Post-FOPA Repeal Era

Cited by 5 publications

References 21 publications

Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives

Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives

A Scoping Review of Current Social Emergency Medicine Research

Emergency Physician Survey on Firearm Injury Prevention: Where Can We Improve?

Contact Info

Product

Resources

About