Effect of Screening for Partner Violence on Women's Quality of Life A Randomized Controlled Trial
Effect of Screening for Partner Violence on Women's Quality of Life A Randomized Controlled Trial
复制标题
DOI：
10.1001/jama.2012.6434
复制
发表时间：
2012-08-15
影响因子：
120.7
通讯作者：
Sadowski, Laura S.
中科院分区：
文献类型：
--
作者：
Klevens, Joanne;Kee, Romina;Sadowski, Laura S.
尽管伴侣暴力筛查已得到许多卫生组织的认可，但没有充分证据表明它具有有益的健康结果。目的与对照组比较，确定计算机化伴侣暴力筛查加提供伴侣暴力资源清单与仅提供伴侣暴力清单对初级保健机构妇女健康的影响。设计、环境和参与者：在伊利诺伊州库克县10个初级卫生保健中心进行的一项3组盲法随机对照试验。参与者于2009年5月至2010年4月入组，并于1年后（48-56周）再次接受访谈。参与者是符合特定纳入标准并在研究地点寻求临床服务的讲英语或西班牙语的妇女。在接触的3537名女性中，2727名符合条件，2708名随机（99%），2364名（87%）在1年后再次接触。参与者的平均年龄为39岁。参与者主要是非拉丁裔非裔美国人（55%）或拉丁裔（37%），高中学历或以下（57%），没有保险（57%）。随机分为3个干预组：(1)伴侣暴力筛查（使用伴侣暴力筛查工具），如果筛查呈阳性，则提供当地伴侣暴力资源列表（n = 909）；(2)伴侣暴力资源列表仅不加屏幕（n = 893）；(3)无屏幕、无伴侣暴力列表对照组（n = 898）。生活质量（QOL，身体和心理健康组成部分）是主要结果，用12项短表（量表范围0-100，美国人口平均50）来衡量。结果随访1年，屏幕加伴侣暴力资源列表组（n = 801，平均得分为46.8,95% CI为46.1-47.4）、伴侣暴力资源列表组（n = 772，平均得分为46.4,95% CI为45.8-47.1）、对照组（n = 791，平均得分为47.2,95% CI为46.5-47.8）或心理健康组件(屏幕加伴侣暴力资源列表组[平均得分，48.3；95% CI, 47.5-49.1]，伴侣暴力资源单组[平均得分，48.0；95% CI, 47.2-48.9]，对照组[平均评分，47.8；95% ci, 47.0-48.6])。在无法工作或无法完成家务的天数上，两组之间也没有差异；住院、急诊或门诊就诊次数；接触伴侣暴力机构的比例；或者伴侣暴力的复发。结论：在初级保健诊所接受治疗的妇女中，提供有或没有筛查的伴侣暴力资源清单并没有改善健康状况。
Context Although partner violence screening has been endorsed by many health organizations, there is insufficient evidence that it has beneficial health outcomes.Objective To determine the effect of computerized screening for partner violence plus provision of a partner violence resource list vs provision of a partner violence list only on women's health in primary care settings, compared with a control group.Design, Setting, and Participants A 3-group blinded randomized controlled trial at 10 primary health care centers in Cook County, Illinois. Participants were enrolled from May 2009-April 2010 and reinterviewed 1 year (range, 48-56 weeks) later. Participants were English- or Spanish-speaking women meeting specific inclusion criteria and seeking clinical services at study sites. Of 3537 women approached, 2727 were eligible, 2708 were randomized (99%), and 2364 (87%) were recontacted 1 year later. Mean age of participants was 39 years. Participants were predominantly non-Latina African American (55%) or Latina (37%), had a high school education or less (57%), and were uninsured (57%).Intervention Randomization into 3 intervention groups: (1) partner violence screen (using the Partner Violence Screen instrument) plus a list of local partner violence resources if screening was positive (n = 909); (2) partner violence resource list only without screen (n = 893); and (3) no-screen, no-partner violence list control group (n = 898).Main Outcome Measures Quality of life (QOL, physical and mental health components) was the primary outcome, measured on the 12-item Short Form (scale range 0-100, mean of 50 for US population).Results At 1-year follow-up, there were no significant differences in the QOL physical health component between the screen plus partner violence resource list group (n = 801; mean score, 46.8; 95% CI, 46.1-47.4), the partner violence resource list only group (n = 772; mean score, 46.4; 95% CI, 45.8-47.1), and the control group (n = 791; mean score, 47.2; 95% CI, 46.5-47.8), or in the mental health component (screen plus partner violence resource list group [mean score, 48.3; 95% CI, 47.5-49.1], the partner violence resource list only group [mean score, 48.0; 95% CI, 47.2-48.9], and the control group [mean score, 47.8; 95% CI, 47.0-48.6]). There were also no differences between groups in days unable to work or complete housework; number of hospitalizations, emergency department, or ambulatory care visits; proportion who contacted a partner violence agency; or recurrence of partner violence.Conclusions Among women receiving care in primary care clinics, providing a partner violence resource list with or without screening did not result in improved health.