Abstract：
BACKGROUND: The concept of patient-provider trust in prenatal adverse childhood experiences (ACEs) screening remains unexplored. This concept analysis illuminates the role of trust in prenatal ACE screening to improve patient-provider relationships, increase patient uptake of ACE screening, and ensure that ACE screening is implemented in a strengths-based, trauma-informed way.
METHODS: A concept analysis was conducted using the Rodgers\' evolutionary method to define the antecedents, attributes, and consequences of this construct. The databases searched were PubMed, PsychInfo, and Scopus between 2010 and 2021. A total of 389 articles were retrieved using the search terms prenatal, adverse childhood experiences screening, adverse childhood experiences, and adverse childhood experiences questionnaire. Included articles for detailed review contained prenatal screening, trauma screening (ACE or other), trust or building trust between patient and health care provider, patient engagement, and shared decision making. Excluded articles were those not in the context of prenatal care and that were exclusively about screening with no discussion about the patient-provider relationship or patient perspectives. A total of 32 articles were reviewed for this concept analysis.
RESULTS: We define trust in prenatal ACE screening as a network of evidence-based attributes that include the timing of the screening, patient familiarity with the health care provider, cultural competence, demystifying trauma, open dialogue between the patient and health care provider, and patient comfort and respect.
CONCLUSIONS: This concept analysis elucidates the importance of ACE screening and provides suggestions for establishing trust in the context of prenatal ACE screening. Results give insight and general guidance for health care providers looking to implement ACE screening in a trauma-informed way. Further research is needed to evaluate pregnant patients\' attitudes toward ACE screening and how a health care provider\'s trauma history might influence their care. More inquiry is needed to understand the racial, ethnic, and cultural barriers to ACE screening.
METHODS: A concept analysis was conducted using the Rodgers\' evolutionary method to define the antecedents, attributes, and consequences of this construct. The databases searched were PubMed, PsychInfo, and Scopus between 2010 and 2021. A total of 389 articles were retrieved using the search terms prenatal, adverse childhood experiences screening, adverse childhood experiences, and adverse childhood experiences questionnaire. Included articles for detailed review contained prenatal screening, trauma screening (ACE or other), trust or building trust between patient and health care provider, patient engagement, and shared decision making. Excluded articles were those not in the context of prenatal care and that were exclusively about screening with no discussion about the patient-provider relationship or patient perspectives. A total of 32 articles were reviewed for this concept analysis.
RESULTS: We define trust in prenatal ACE screening as a network of evidence-based attributes that include the timing of the screening, patient familiarity with the health care provider, cultural competence, demystifying trauma, open dialogue between the patient and health care provider, and patient comfort and respect.
CONCLUSIONS: This concept analysis elucidates the importance of ACE screening and provides suggestions for establishing trust in the context of prenatal ACE screening. Results give insight and general guidance for health care providers looking to implement ACE screening in a trauma-informed way. Further research is needed to evaluate pregnant patients\' attitudes toward ACE screening and how a health care provider\'s trauma history might influence their care. More inquiry is needed to understand the racial, ethnic, and cultural barriers to ACE screening.
摘要：
背景：在产前不良儿童经历（ACE）筛查中，患者-提供者信任的概念仍未被探索。此概念分析阐明了信任在产前ACE筛查中的作用，以改善患者与提供者的关系，增加患者对ACE筛查的摄取，并确保ACE筛查以优势为基础实施，创伤知情的方式。
方法：使用罗杰斯进化方法进行了概念分析，以定义前因，属性，以及这种结构的后果。搜索的数据库是PubMed,PsychInfo,和Scopus在2010年至2021年之间。使用产前搜索词共检索到389篇文章，不良童年经历筛查，不利的童年经历，和不良童年经历问卷。包括用于详细审查的文章包含产前筛查，创伤筛查（ACE或其他），患者和医疗保健提供者之间的信任或建立信任，患者参与,共同决策。排除的文章是那些不是在产前护理的背景下，并且完全是关于筛查，没有讨论患者与提供者的关系或患者观点。本概念分析共回顾了32篇文章。
结果：我们将产前ACE筛查中的信任定义为基于证据的属性网络，包括筛查的时机，患者对医疗保健提供者的熟悉程度，文化能力,揭开创伤的神秘面纱，病人和医疗保健提供者之间的公开对话，和病人的安慰和尊重。
结论：本概念分析阐明了ACE筛查的重要性，并为在产前ACE筛查中建立信任提供了建议。结果为希望以创伤知情方式实施ACE筛查的医疗保健提供者提供了见解和一般指导。需要进一步的研究来评估妊娠患者对ACE筛查的态度，以及医疗保健提供者的创伤史如何影响他们的护理。需要更多的调查来了解种族，民族,以及ACE筛查的文化障碍。
方法：使用罗杰斯进化方法进行了概念分析，以定义前因，属性，以及这种结构的后果。搜索的数据库是PubMed,PsychInfo,和Scopus在2010年至2021年之间。使用产前搜索词共检索到389篇文章，不良童年经历筛查，不利的童年经历，和不良童年经历问卷。包括用于详细审查的文章包含产前筛查，创伤筛查（ACE或其他），患者和医疗保健提供者之间的信任或建立信任，患者参与,共同决策。排除的文章是那些不是在产前护理的背景下，并且完全是关于筛查，没有讨论患者与提供者的关系或患者观点。本概念分析共回顾了32篇文章。
结果：我们将产前ACE筛查中的信任定义为基于证据的属性网络，包括筛查的时机，患者对医疗保健提供者的熟悉程度，文化能力,揭开创伤的神秘面纱，病人和医疗保健提供者之间的公开对话，和病人的安慰和尊重。
结论：本概念分析阐明了ACE筛查的重要性，并为在产前ACE筛查中建立信任提供了建议。结果为希望以创伤知情方式实施ACE筛查的医疗保健提供者提供了见解和一般指导。需要进一步的研究来评估妊娠患者对ACE筛查的态度，以及医疗保健提供者的创伤史如何影响他们的护理。需要更多的调查来了解种族，民族,以及ACE筛查的文化障碍。
