GP views on their role in bullying disclosure by children and young people in the community: a cross-sectional qualitative study in English primary care

The perspective and preferences of adolescents in addressing sensitive health topics with their family doctor - The influence of childhood adversities

OBJECTIVE

To investigate whether adverse childhood experiences (ACEs) influence adolescents' perspectives and preferences in addressing sensitive health topics and their general perception of family doctor's care, and also to study the impact of addressing sensitive topics regarding adolescents' health-related quality of life (HRQoL).

METHODS

Two hundred and forty-five tenth to twelfth grade students completed a questionnaire, comprising the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and scales to assess experiences, preferences, perspectives, the general perception of family doctor visits, and HRQoL.

RESULTS

The total CTQ-SF score negatively predicted the preferences in addressing sensitive topics and the general perception of family doctor's care. Being asked about sensitive topics positively predicted the perception of family doctor's care and was positively associated with three dimensions of HRQoL.

CONCLUSION

The greater the frequency of ACEs reported by the adolescents, the less willing they were to be asked about sensitive topics and the worse was the general perception of family doctor's care. However, when asked about sensitive topics, the adolescents had a more positive general perception and a better HRQoL.

PRACTICE IMPLICATIONS

This study helps family doctors understand the need to adapt communication skills and to build a trustful relationship with adolescents who reported ACEs.

Attitudes, Self-Confidence, and Knowledge of Primary Care Professionals towards School Bullying

Attitudes, practices, and knowledge about bullying were evaluated in a sample of 274 primary care professionals, including general practitioners, pediatricians, community, pediatric and school nurses, and residents of these specialties. This study was based on a mixed method with a parallel convergent design without dominance between phases, data were collected concurrently, and conversion of the results from both phases was carried out during data interpretation. The quantitative phase had a cross-sectional observational design, using The Healthcare Provider's Practices, Attitudes, Self-confidence, and Knowledge Regarding Bullying Questionnaire as an instrument. Descriptive and bivariate analyses were performed, which showed a positive correlation between higher self-confidence and knowledge scores and a greater predisposition to detect cases. However, although the dimensions of attitudes and knowledge yielded generally high data, low self-confidence was evident in addressing this problem. In addition, a lack of clear guidelines in the workplace was expressed, highlighting the need to create and provide specific resources to intervene in bullying in said context, which could develop an improvement in self-confidence, leading to greater well-being for the educational community regarding bullying.

Bullying in children: impact on child health

Bullying in childhood is a major public health problem that increases the risk of poor health, social and educational outcomes in childhood and adolescence. These consequences are felt by all those involved in bullying (bullies, victims and bully-victims) and are now recognised to propagate deep into adulthood. Cyberbullying is a relatively new type of bullying in addition to the traditional forms of direct physical, direct verbal and indirect bullying. Children who are perceived as being 'different' in any way are at greater risk of victimisation, with physical appearance being the most frequent trigger of childhood bullying. Globally, one in three children have been bullied in the past 30 days, although there is substantial regional variation in the prevalence and type of bullying experienced. The consequences of childhood bullying can be categorised into three broad categories: educational consequences during childhood, health consequences during childhood and all consequences during adulthood. Many dose-response relationships exist between the frequency and intensity of bullying experienced and the severity of negative health consequence reported. The majority of victims of cyberbullying are also victims of traditional bullying, meaning cyberbullying creates very few additional victims. Overall, adverse mental health outcomes due to bullying in childhood most severely impact on bully-victims. Bullying prevention is vital for the achievement of the Sustainable Development Goals, with whole-school cooperative learning interventions having the strongest evidence base for successful outcomes. Clear management and referral pathways for health professionals dealing with childhood bullying are lacking in both primary and secondary care, although specialist services are available locally and online.