Counseling parents about firearm safety – includes editor note – adapted from the Archives of Pediatric and Adolescent Medicine 1995;149:973-7 – Tips from Other Journals
Firearms are the second most common cause of injury deaths among children aged 10 to 14 years and the second most common cause of death among adolescents aged 15 to 19 years. Household handgun ownership is associated with a 5.8-fold risk of suicide and 1.9-fold risk of homicide among adults in the house. Unsafe firearm storage is associated with an even higher risk of death. Grossman and colleagues conducted a cross-sectional survey of family physicians and pediatricians in one state to evaluate attitudes, beliefs and office-based firearm safety counseling practices.
A total of 979 physicians returned completed questionnaires. A majority of responding physicians agreed that families with children should not keep firearms in the home. Compared with physicians who owned guns (32 percent), physicians who did not own guns were 15 times more likely to advocate that parents of children not keep firearms. Few physicians believed that counseling parents to remove existing handguns from the home would be effective. However, 97 percent agreed that parents with handguns should be told to store ammunition and unloaded guns in separate locked cabinets.
Forty-seven percent of family physicians and 70 percent of pediatricians believed that physicians have a responsibility to counsel patients about firearm safety. However, only 8 percent of family physicians and 20 percent of pediatricians said that they currently counsel more than 5 percent of their patients.
The authors conclude that although most family physicians and pediatricians agree that it is the physician’s responsibility to counsel patients about firearm safety, few physicians actually offer such guidance. They suggest that at least half of the physicians in this study would benefit from an intervention to improve knowledge and counseling skills. (Grossman DC, et al. Firearm injury prevention counseling by pediatricians and family physicians. Arch Pediatr Adolesc Med 1995;149:973-7.)
EDITOR’S NOTE: Family physicians and pediatricians are in a unique position to help parents protect and promote the health of their children. Counseling by a physician has been shown to be effective in a variety of preventive topics, including immunizations, nutrition and protection from injury. Despite the known benefits, firearm safety has not, until recently, been a topic of discussion between physicians and families, perhaps because of its social and political sensitivity. In this study, virtually all physicians agreed that parents should be asked about ownership of firearms and those who own handguns should be counseled to store guns and ammunition separately in locked cabinets. Firearm safety is an important topic for anticipatory preventive guidance.
COPYRIGHT 1996 American Academy of Family Physicians
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