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The prevalence and clinical correlates of adverse childhood experiences in a cross-sectional study of primary care patients with cardiometabolic disease or risk factors.
BMC Cardiovascular Disorders ( IF 2.0 ) Pub Date : 2019-12-19 , DOI: 10.1186/s12872-019-01277-3
Robert G Maunder 1 , David W Tannenbaum 2, 3 , Joanne A Permaul 2 , Melissa Nutik 2, 3 , Cleo Haber 3, 4 , Mira Mitri 2, 3 , Daniela Costantini 2, 3 , Jonathan J Hunter 1
Affiliation  

BACKGROUND Adverse childhood experiences (ACEs) are associated with risk of poor adult health, including cardiometabolic diseases. Little is known about the correlates of ACEs for adults who have already developed cardiometabolic diseases, or who are at elevated risk. METHODS Adult primary care patients with cardiometabolic disease (hypertension, diabetes, stroke, angina, myocardial infarction, coronary artery bypass graft, angioplasty) or with a risk factor (obesity, smoking, high cholesterol, family history) were surveyed regarding ACEs, psychological distress, attachment insecurity, quality of life, behavior change goals, stages of change, and attitudes toward potential prevention strategies. RESULTS Of 387 eligible patients, 74% completed the ACEs survey. Exposure to ACEs was reported by 174 participants (61%). Controlling for age, gender, relationship status and income, number of ACEs was associated with psychological distress (F = 3.7, p = .01), quality of life (F = 8.9, p = .001), attachment anxiety (F = 3.4, p = .02), drinking alcohol most days (F = 4.0, p = .008) and smoking (F = 2.7, p = .04). Greater ACE exposure was associated with less likelihood of selecting diet or physical activity as a behavior change goal (linear-by-linear association p = .009). Stage of change was not associated with ACEs. ACEs exposure was not related to preferred resources for behavior change. CONCLUSIONS ACEs are common among patients at cardiometabolic risk and are related to quality of life, psychological factors that influence cardiometabolic outcomes and behavior change goals. ACEs should be taken into account when managing cardiometabolic risk in family medicine.

中文翻译:

在患有心脏代谢疾病或危险因素的初级保健患者的横断面研究中,不良儿童时期的患病率和临床相关性。

背景技术不良的童年经历(ACE)与包括心脏代谢疾病在内的不良成年人健康风险相关。对于已经发展出心脏代谢疾病或风险较高的成年人,ACEs的相关性知之甚少。方法对患有心脏代谢疾病(高血压,糖尿病,中风,心绞痛,心肌梗塞,冠状动脉搭桥术,血管成形术)或具有危险因素(肥胖,吸烟,高胆固醇,家族史)的成人初级保健患者进行有关ACEs,心理困扰的调查。 ,依恋不安全感,生活质量,行为改变目标,改变阶段以及对潜在预防策略的态度。结果在387名合格患者中,有74%完成了ACEs调查。174名参与者(61%)报告了接触ACEs。控制年龄,性别,关系状态和收入,ACE数量与心理困扰(F = 3.7,p = .01),生活质量(F = 8.9,p = .001),依恋焦虑(F = 3.4,p = .02) ,大多数情况下饮酒(F = 4.0,p = .008)和吸烟(F = 2.7,p = .04)。较高的ACE暴露与选择饮食或身体活动作为行为改变目标的可能性降低相关(线性逐线性关联p = .009)。变更阶段与ACE无关。ACE暴露与行为改变的首选资源无关。结论ACEs在具有心脏代谢风险的患者中很常见,并且与生活质量,影响心脏代谢结果的心理因素以及行为改变目标有关。在管理家庭医学中的心脏代谢风险时,应考虑使用ACE。ACEs的数量与心理困扰(F = 3.7,p = .01),生活质量(F = 8.9,p = .001),依恋焦虑(F = 3.4,p = .02),大部分时间饮酒有关(F = 4.0,p = .008)和吸烟(F = 2.7,p = .04)。较高的ACE暴露与选择饮食或身体活动作为行为改变目标的可能性降低相关(线性逐线性关联p = .009)。变更阶段与ACE无关。ACE暴露与行为改变的首选资源无关。结论ACEs在具有心脏代谢风险的患者中很常见,并且与生活质量,影响心脏代谢结果的心理因素以及行为改变目标有关。在管理家庭医学中的心脏代谢风险时,应考虑使用ACE。ACEs的数量与心理困扰(F = 3.7,p = .01),生活质量(F = 8.9,p = .001),依恋焦虑(F = 3.4,p = .02),大部分时间饮酒有关(F = 4.0,p = .008)和吸烟(F = 2.7,p = .04)。较高的ACE暴露与选择饮食或身体活动作为行为改变目标的可能性降低相关(线性逐线性关联p = .009)。变更阶段与ACE无关。ACE暴露与行为改变的首选资源无关。结论ACEs在具有心脏代谢风险的患者中很常见,并且与生活质量,影响心脏代谢结果的心理因素以及行为改变目标有关。在管理家庭医学中的心脏代谢风险时,应考虑使用ACE。
更新日期:2019-12-27
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