Primary care identification and referral to improve safety of women experiencing domestic violence (IRIS): protocol for a pragmatic cluster randomised controlled trial.
Primary care identification and referral to improve safety of women experiencing domestic violence (IRIS): protocol for a pragmatic cluster randomised controlled trial.
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DOI：
10.1186/1471-2458-10-54
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发表时间：
2010-02-02
影响因子：
4.5
通讯作者：
Feder G
中科院分区：
文献类型：
--
作者：
Gregory A;Ramsay J;Agnew-Davies R;Baird K;Devine A;Dunne D;Eldridge S;Howell A;Johnson M;Rutterford C;Sharp D;Feder G
家庭暴力，可能是心理、身体、性、经济或情感上的，是一个主要的公共卫生问题，因为对经历过家庭暴力的妇女及其目睹家庭暴力的子女造成长期健康后果，在接受全科治疗的妇女群体中，过去一年中来自伴侣或前伴侣的身体或性虐待的发生率为6%至23%，终生患病率为21%到55%。家庭暴力在一般实践中特别重要，因为妇女与初级保健临床医生有许多接触，而且遭受虐待的妇女认为医生和护士是她们希望得到支持的专业人员。然而，卫生专业人员很少询问家庭暴力问题，而且很少或根本没有接受过如何应对披露虐待行为的培训。本方案描述了IRIS，一项实用的整群随机对照试验，以全科实践作为随机化单位。我们的试验测试的有效性和成本效益的培训和支持计划，针对一般的做法团队。主要成果是将妇女转介给专门的家庭暴力机构。英国两个城市（布里斯托和伦敦）的48家诊所采用最小化方法随机分配到干预组和对照组。该干预措施以教育推广框架中的成人学习模式为基础，旨在消除向妇女询问家庭暴力问题的障碍，并鼓励对披露和转介专门的家庭暴力机构作出适当反应。在每个干预实践中，与临床医生和行政人员举行多学科培训课程，定期向实践团队反馈识别和转诊数据。干预实践有一个提示，询问有关滥用集成在电子病历系统。干预措施的其他组成部分包括在每一个实践中的IRIS冠军和直接转介途径，以指定的家庭暴力倡导者。这是欧洲第一项关于改善家庭暴力医疗保健反应的干预措施的随机对照试验。调查结果将有可能为培训和服务提供提供信息。ISRCTN74012786
Domestic violence, which may be psychological, physical, sexual, financial or emotional, is a major public health problem due to the long-term health consequences for women who have experienced it and for their children who witness it. In populations of women attending general practice, the prevalence of physical or sexual abuse in the past year from a partner or ex-partner ranges from 6 to 23%, and lifetime prevalence from 21 to 55%. Domestic violence is particularly important in general practice because women have many contacts with primary care clinicians and because women experiencing abuse identify doctors and nurses as professionals from whom they would like to get support. Yet health professionals rarely ask about domestic violence and have little or no training in how to respond to disclosure of abuse. This protocol describes IRIS, a pragmatic cluster randomised controlled trial with the general practice as unit of randomisation. Our trial tests the effectiveness and cost-effectiveness of a training and support programme targeted at general practice teams. The primary outcome is referral of women to specialist domestic violence agencies. Forty-eight practices in two UK cities (Bristol and London) are randomly allocated, using minimisation, into intervention and control groups. The intervention, based on an adult learning model in an educational outreach framework, has been designed to address barriers to asking women about domestic violence and to encourage appropriate responses to disclosure and referral to specialist domestic violence agencies. Multidisciplinary training sessions are held with clinicians and administrative staff in each of the intervention practices, with periodic feedback of identification and referral data to practice teams. Intervention practices have a prompt to ask about abuse integrated in the electronic medical record system. Other components of the intervention include an IRIS champion in each practice and a direct referral pathway to a named domestic violence advocate. This is the first European randomised controlled trial of an intervention to improve the health care response to domestic violence. The findings will have the potential to inform training and service provision. ISRCTN74012786
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影响因子：
2.1
作者：
Jejeebhoy, SJ
通讯作者：
Jejeebhoy, SJ
影响因子：
10.5
作者：
Coid, J;Petruckevitch, A;Feder, G
通讯作者：
Feder, G
影响因子：
2.1
作者：
McFarlane, J;Soeken, K;Wiist, W
通讯作者：
Wiist, W
影响因子：
120.7
作者：
MacMillan, Harriet L.;Wathen, C. Nadine;McNutt, Louise-Anne
通讯作者：
McNutt, Louise-Anne
DOI：
10.3109/01460869509087269
发表时间：
1995-07-01
期刊：
Issues in comprehensive pediatric nursing
影响因子：
--
作者：
Attala, J M;Bauza, K;Vieira, D
通讯作者：
Vieira, D