The value of intervening for intimate partner violence in South African primary care: project evaluation.
The value of intervening for intimate partner violence in South African primary care: project evaluation.
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DOI：
10.1136/bmjopen-2011-000254
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发表时间：
2011
期刊：
影响因子：
2.9
通讯作者：
Mash RJ
中科院分区：
文献类型：
--
作者：
Joyner K;Mash RJ
亲密伴侣暴力是南非疾病负担的一个重要因素。在初级保健中缺乏基于证据的IPV方法。这项研究评估了一个项目，实施了南非的协议，筛选和管理IPV。本文主要从女性IPV幸存者的角度报道了这种干预措施的好处。这是一个涉及两个城市和三个农村初级保健设施的项目评价。在4-8周内，初级保健提供者筛选了过去24个月内有IPV病史的成年女性，并将其转诊给研究护士。 研究护士根据方案对女性进行评估和管理。研究人员在一个月后采访了参与者，以确定他们对护理计划的遵守情况以及他们对干预措施的看法。 总共有168名妇女接受了援助，124名（73.8%）返回接受后续治疗。情感（139，82.7%），身体（115，68.5%），性（72，42.9%）和经济虐待（72，42.9%）是常见的，114（67.9%）处于高/严重的伤害风险。对管理计划的依从性从梅毒检测10/25（40.0%）到咨询精神科护士28/58（48.3%）到获得保护令28/28（100.0%）不等。超过75%的人认为他们的护理的所有方面都是有帮助的，除了来自非营利组织的法律的建议。妇女报告说，这对她们的心理健康、减少酗酒、改善关系、提高自我效能和减少虐待行为有重大好处。两个特征似乎特别重要：与护士互动的风格和评估的综合性。在初级保健经验的女性IPV幸存者受益于移情，全面的方法来评估和协助临床，心理，社会和法律的方面。初级保健管理人员应设法将其纳入初级保健服务，并进一步评估。经历IPV的女性是否发现初级保健的评估和管理有益？他们遵循了护理计划的哪些方面？他们认为护理计划的哪些方面最有帮助？在初级保健中被诊断患有IPV的妇女认为受益于干预措施，其特征是对临床，心理，社会和法律的方面采取移情，非判断和综合方法。妇女报告说，她们的心理健康、饮酒、人际关系和虐待行为经历都有好处。IPV幸存者在获得保护令、提出刑事指控和干预后怀孕检测方面最为积极主动。对初级保健中的全面生物心理社会和法医干预进行了测试，确保后续行动显示其价值。这项研究是在通常的工作条件和资源可用性，使调查结果适用于初级保健背景下进行的。虽然这项研究只涉及五个专门选定的设施，农村/城市的组合使它可能是相当典型的。不同的研究者进行的后续访谈降低了谄媚偏见。1个月后的随访时间太短，无法预测干预的长期后果。 该研究通过参与者的自我报告间接测量了干预对虐待的影响。
Intimate partner violence (IPV) is an important contributor to the burden of disease in South Africa. Evidence-based approaches to IPV in primary care are lacking. This study evaluated a project that implemented a South African protocol for screening and managing IPV. This article reports primarily on the benefits of this intervention from the perspective of women IPV survivors. This was a project evaluation involving two urban and three rural primary care facilities. Over 4–8 weeks primary care providers screened adult women for a history of IPV within the previous 24 months and offered referral to the study nurse. The study nurse assessed and managed the women according to the protocol. Researchers interviewed the participants 1 month later to ascertain adherence to their care plan and their views on the intervention. In total, 168 women were assisted and 124 (73.8%) returned for follow-up. Emotional (139, 82.7%), physical (115, 68.5%), sexual (72, 42.9%) and financial abuse (72, 42.9%) was common and 114 (67.9%) were at high/severe risk of harm. Adherence to the management plan ranged from testing for syphilis 10/25 (40.0%) to consulting a psychiatric nurse 28/58 (48.3%) to obtaining a protection order 28/28 (100.0%). Over 75% perceived all aspects of their care as helpful, except for legal advice from a non-profit organisation. Women reported significant benefits to their mental health, reduced alcohol abuse, improved relationships, increased self-efficacy and reduced abusive behaviour. Two characteristics seemed particularly important: the style of interaction with the nurse and the comprehensive nature of the assessment. Female IPV survivors in primary care experience benefit from an empathic, comprehensive approach to assessing and assisting with the clinical, mental, social and legal aspects. Primary care managers should find ways to integrate this into primary care services and evaluate it further. Did women experiencing IPV find assessment and management in primary care beneficial? What aspects of their care plan did they adhere to? What aspects of their care plan did they find most helpful? Women diagnosed with IPV in primary care perceive benefit from an intervention characterised by both empathic, non-judgemental and a comprehensive approach to the clinical, mental, social and legal aspects. Women reported benefits to their mental health, alcohol use, relationships and experience of abusive behaviour. IPV survivors were most proactive about securing protection orders, laying criminal charges and testing for pregnancy post-intervention. A comprehensive biopsychosocial and forensic intervention in primary care was tested, securing follow-up that revealed its value. The study was conducted under usual working conditions and resource availability making the findings applicable to the primary care context. Although the study only involved five purposely selected facilities, the rural/urban mix makes it likely that these are fairly typical. Obsequiousness bias was reduced by different researchers conducting the follow-up interviews. Follow-up after 1 month is too short to predict the longer-term consequences of the intervention. The study measured the effect of the intervention on the abuse indirectly via participant self-reports.
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影响因子：
1.1
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