Responding to intimate partner violence: Healthcare providers' current practices and views on integrating a safety decision aid into primary care settings
Responding to intimate partner violence: Healthcare providers' current practices and views on integrating a safety decision aid into primary care settings
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DOI：
10.1002/nur.21853
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发表时间：
2018-04-01
影响因子：
2
通讯作者：
Glass, Nancy E.
中科院分区：
文献类型：
--
作者：
Alvarez, Carmen;Debnam, Katrina;Glass, Nancy E.
在初级保健机构中，为亲密伴侣暴力幸存者提供的支持性护理仍然有限。由于缺乏针对IPV的语言和文化上适当的干预措施，低收入和讲西班牙语的IPV幸存者处境更加不利。我们对包括医生、护士和社会工作者在内的17名卫生保健工作者进行了半结构化的个人访谈，以描述主要为低收入拉丁裔人群服务的卫生保健工作者目前如何筛查和应对IPV披露，并探讨将交互式、个性化的安全决策辅助应用程序myplan应用程序整合到诊所环境中的可接受性。尽管认识到IPV是一个问题，但没有一个临床场所有指导筛查和应对IPV披露的方案。不同地点的筛查做法各不相同，有时由医疗助理在提供者访问之前进行，有时由医生或护士提供者进行。当IPV被披露时，它通常是在评估出现的问题，如睡眠不佳或焦虑。大多数卫生保健工作者认为，临床和社区资源是有限的，他们的病人经历IPV。在可能的情况下，把“暖手”交给社会工作者是最常见的应对策略；此外，还向妇女提供了可用资源的信息，如热线和安全屋。我们讨论了结构、家庭和个人障碍，以获取缺乏服务的妇女安全资源，并审查了一个易于访问的安全决策应用程序，如myPlan，如何为妇女提供资源，以安全地为她的情况量身定制行动计划。
Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting. Despite recognition of IPV as a problem, none of the clinical sites had a protocol to guide screening and response to IPV disclosure. Screening practices varied across the sites, sometimes conducted by medical assistants prior to the provider visit and other times by the physician or nurse provider. When IPV was disclosed, it was often during assessment for a presenting problem such as poor sleep or anxiety. Most healthcare workers felt that clinical and community resources were limited for their patients experiencing IPV. The " warmhand-off" to a social worker was the mostcommonresponse strategy when possible; otherwise, womenwere given information about available resources such as hotlines and safe houses. We discuss structural, family, and individual barriers to accessing safety resources for underserved women and review how an easily accessible safety decision app, such as myPlan, could be a resource for women to safely tailor an action plan for her situation.