Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting.
Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting.
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DOI：
10.1371/journal.pone.0205485
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Peters TJ
中科院分区：
文献类型：
--
作者：
Ferrari G;Feder G;Agnew-Davies R;Bailey JE;Hollinghurst S;Howard L;Howarth E;Sardinha L;Sharp D;Peters TJ
家庭暴力和虐待（DVA）的经历与精神疾病有关。宣传对女性DVA幸存者的心理健康结果影响不大，心理干预对这一人群的有效性存在不确定性。测试由倡导者对DVA幸存者进行心理干预的有效性。常规DVA倡导与倡导+心理干预的实用平行组个体随机对照试验。统计学家和研究人员对分组设盲。设置：专业DVA机构;两个英国城市。参加者：16岁及以上妇女，正在接受家庭暴力和退伍军人服务。八次心理咨询专家会议，两次后续会议。12个月时的主要结局：抑郁症状（PHQ-9）和心理困扰（CORE-OM）。主要分析：连续（二元）结局的意向治疗线性（逻辑）回归模型。招募了263名妇女（78名在庇护所/避难所，185名在社区），2名退出（1名社区，对照组; 1名干预，避难所组），1名因违反方案而被排除在研究之外（社区，对照组），130名在干预组，130名在对照组。征聘工作于2013年6月结束。12-1个月随访：64%。在12个月的随访中，干预组妇女的心理健康得到了更大的改善。干预组和对照组之间的平均CORE-OM评分差异：-3.3分（95% CI -5.5至-1.2）。干预组和对照组之间平均PHQ-9评分的差异：-2.2（95% CI -4.1至-0.3）。在12个月时，35%的干预组和55%的对照组高于CORE-OM-2临床阈值（OR 0.32，95% CI 0.16 - 0.64）; 29%的干预组和46%的对照组高于PHQ-9临床阈值（OR 0.41，95%CI 0.21至0.81），12个月时保留率为64%。与正常的宣传护理相比，DVA倡导者提供的八次心理干预在心理健康结局方面产生了临床相关的改善。ISRCTN登记研究ISRCTN 58561170原始研究3675/3750
Experience of domestic violence and abuse (DVA) is associated with mental illness. Advocacy has little effect on mental health outcomes of female DVA survivors and there is uncertainty about the effectiveness of psychological interventions for this population. To test effectiveness of a psychological intervention delivered by advocates to DVA survivors. Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Statistician and researchers blinded to group assignment. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16 years and older accessing DVA services. Eight specialist psychological advocacy (SPA) sessions with two follow up sessions. Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat linear (logistic) regression model for continuous (binary) outcomes. 263 women recruited (78 in shelter/refuge, 185 in community), 2 withdrew (1 community, control group; 1 intervention, refuge group), 1 was excluded from the study for protocol violation (community, control group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 64%. At 12-month follow up greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM -2clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81), 64% retention at 12 months An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care. ISRCTN registry ISRCTN58561170 Original Research 3675/3750
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