A comprehensive model for intimate partner violence in South African primary care: action research
A comprehensive model for intimate partner violence in South African primary care: action research
复制标题
DOI：
10.1186/1472-6963-12-399
复制
发表时间：
2012-11-14
影响因子：
2.8
通讯作者：
Mash, Bob
中科院分区：
文献类型：
--
作者：
Joyner, Kate;Mash, Bob
背景：尽管有大量证据表明亲密伴侣暴力(IPV)是世界范围内的一个公共卫生问题，但在发展和实施足够全面的卫生服务方面却取得了不大的进展。这项研究旨在实施、评估和调整已公布的IPV筛查和管理方案，并推荐一种可以在我们欠发达的南非初级卫生保健系统中规模化的护理模式。方法：专业行动研究利用一个由4名护士、1名医生和1名定性研究人员组成的合作调查小组。调查小组在两个城市和三个农村初级保健机构实施了该议定书。在14个月的时间里，该小组反思了他们的经验，修改了方案，并就实用但全面的护理模式提出了建议。结果：原始方案必须进行修改，以满足对初级保健提供者的期望、过度的法医定位、在心理健康方面缺乏深度、危险评估和安全规划过程的有效性，以及对持续授权和支持的需求。结果形成了一个三级模式：由初级保健提供者提供病例发现和临床护理；由“IPV倡导者”提供心理、社会和法律援助，然后是团体赋权进程；然后是持续的社区支持小组。结论：调查过程导致了一种在设施层面整合的跨部门综合护理模式，目前正在南非西开普省试行。
Background: Despite extensive evidence on the magnitude of intimate partner violence (IPV) as a public health problem worldwide, insubstantial progress has been made in the development and implementation of sufficiently comprehensive health services. This study aimed to implement, evaluate and adapt a published protocol for the screening and management of IPV and to recommend a model of care that could be taken to scale in our underdeveloped South African primary health care system.Methods: Professional action research utilised a co-operative inquiry group that consisted of four nurses, one doctor and a qualitative researcher. The inquiry group implemented the protocol in two urban and three rural primary care facilities. Over a period of 14 months the group reflected on their experience, modified the protocol and developed recommendations on a practical but comprehensive model of care.Results: The original protocol had to be adapted in terms of its expectations of the primary care providers, overly forensic orientation, lack of depth in terms of mental health, validity of the danger assessment and safety planning process, and need for ongoing empowerment and support. A three-tier model resulted: case finding and clinical care provision by primary care providers; psychological, social and legal assistance by 'IPV champions' followed by a group empowerment process; and then ongoing community-based support groups.Conclusion: The inquiry process led to a model of comprehensive and intersectoral care that is integrated at the facility level and which is now being piloted in the Western Cape, South Africa.