PRimary care rEsponse to domestic violence and abuse in the COvid-19 panDEmic (PRECODE): protocol of a rapid mixed-methods study in the UK.
PRimary care rEsponse to domestic violence and abuse in the COvid-19 panDEmic (PRECODE): protocol of a rapid mixed-methods study in the UK.
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DOI：
10.1186/s12875-021-01447-3
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发表时间：
2021-05-12
影响因子：
2.9
通讯作者：
Dowrick A
中科院分区：
文献类型：
--
作者：
Szilassy E;Barbosa EC;Dixon S;Feder G;Griffiths C;Johnson M;De Simoni A;Wileman V;Panovska-Griffiths J;Dowrick A
英国于COVID-19疫情期间实施封锁，导致系统转向远程基层医疗咨询，同时家庭暴力及虐待（DVA）的发生率增加。封锁特定的DVA披露障碍减少了DVA检测和转诊的机会。预编码（PRIMARY CARE RESPONSE TO MANUFACTURE AND ABLATION IN THE COVID-19 panDEmic）研究将包括定量分析疫情对IRIS转诊的影响（识别和转诊以提高安全性）向英国DVA机构提供经过培训的一般实践，并对临床医生应对受DVA影响的患者的经验进行定性分析，以及他们过渡到远程DVA培训所做的调整患者支持。PRECODE采用快速混合方法设计，将利用定性数据和四年多的转诊时间序列数据，在全国范围内探索和解释大流行之前和期间DVA转诊和支持的动态。我们会根据定期收集的数据，对转介至DVA服务的时间数列进行中断时间数列及非线性回归分析，包括敏感度分析，以评估疫情及相关封城措施对转介至IRIS计划的影响，并分析转介个案变动的主要决定因素。我们亦会进行一项以访谈和观察为基础的定性研究，以了解在大流行之前、期间及之后，基层医疗对DVA的反应的变化、相关性和可行性。使用快速分析和综合对定量和定性结果进行三角测量，将能够阐明初级保健对DVA反应的多尺度趋势以及这些反应在大流行期间发生变化的复杂机制。我们的研究结果将通知远程初级保健和DVA服务响应的服务重新配置的实施。了解在大流行期间对DVA的临床和服务反应的适应性，对于在大流行之后发展基于证据的有效远程支持和转诊至关重要。PRECODE是一项观察性流行病学研究，而不是干预评估或试验。我们不会报告对人类参与者的干预结果。
The implementation of lockdowns in the UK during the COVID-19 pandemic resulted in a system switch to remote primary care consulting at the same time as the incidence of domestic violence and abuse (DVA) increased. Lockdown-specific barriers to disclosure of DVA reduced the opportunity for DVA detection and referral. The PRECODE (PRimary care rEsponse to domestic violence and abuse in the COvid-19 panDEmic) study will comprise quantitative analysis of the impact of the pandemic on referrals from IRIS (Identification and Referral to Improve Safety) trained general practices to DVA agencies in the UK and qualitative analysis of the experiences of clinicians responding to patients affected by DVA and adaptations they have made transitioning to remote DVA training and patient support. Using a rapid mixed method design, PRECODE will explore and explain the dynamics of DVA referrals and support before and during the pandemic on a national scale using qualitative data and over four years of referrals time series data. We will undertake interrupted-time series and non-linear regression analysis, including sensitivity analyses, on time series of referrals to DVA services from routinely collected data to evaluate the impact of the pandemic and associated lockdowns on referrals to the IRIS Programme, and analyse key determinants associated with changes in referrals. We will also conduct an interview- and observation-based qualitative study to understand the variation, relevance and feasibility of primary care responses to DVA before and during the pandemic and its aftermath. The triangulation of quantitative and qualitative findings using rapid analysis and synthesis will enable the articulation of multiscale trends in primary care responses to DVA and complex mechanisms by which these responses have changed during the pandemic. Our findings will inform the implementation of remote primary care and DVA service responses as services re-configure. Understanding the adaptation of clinical and service responses to DVA during the pandemic is crucial for the development of evidence-based, effective remote support and referral beyond the pandemic. PRECODE is an observational epidemiologic study, not an intervention evaluation or trial. We will not be reporting results of an intervention on human participants.
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