Boston Violence Intervention Advocacy Program: A Qualitative Study of Client Experiences and Perceived Effect
Boston Violence Intervention Advocacy Program: A Qualitative Study of Client Experiences and Perceived Effect
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DOI：
10.1111/acem.12409
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发表时间：
2014-07-01
影响因子：
4.4
通讯作者：
Mitchell, Patricia M.
中科院分区：
文献类型：
--
作者：
James, Thea L.;Bibi, Salma;Mitchell, Patricia M.
目的：本研究旨在探索客户的经历，并为了解他们对波士顿医疗中心 (BMC) 暴力干预倡导计划 (VIAP) 有效性的看法提供背景基础。方法：这是一项探索性定性研究，于 2011 年 7 月 1 日至 2012 年 2 月 24 日在城市一级创伤中心进行。急诊科 (ED) 患者年龄超过 18 岁，患有穿透性创伤，并且参加了VIAP，有资格。两名不属于 VIAP 的经过培训的定性访谈员获得了同意，并进行了深入的半结构化访谈。采访内容被录音、转录、去识别化、编码和分析。与扎根理论一致的主题内容分析用于确定与客户 VIAP 体验、生活环境、受伤后身心康复的挑战、VIAP 提供的服务以及对 VIAP 有效性的看法相关的主题。结果：对 20 名受试者进行了访谈。大多数是男性、非裔美国人，年龄不到 30 岁，反映了整个项目的客户群。大多数受试者认为他们的倡导者是生活中关心他人的成年人，并引用了同伴支持模式中有助于建立信任关系的方面。治愈的主要挑战是恐惧和安全、信任、作为应对机制的孤立、痛苦和创伤后应激障碍（PTSD）的症状。每个主题都提到了 VIAP 倡导者提供的重要服务。大多数受试者明确表示，他们对 VIAP 有积极的体验，并认为倡导者的角色具有积极影响，提供以客户为中心的倡导、教育和支持。 结论：本研究深入了解 20 位 BMC VIAP 客户的生活，并了解他们独特的挑战。参与者描述了他们在通过与关心、支持的成年人的联系来康复的过程中积极的、改变生活的行为。从这项研究中获得的信息将有助于 VIAP 进一步支持其客户。然而，未来的研究需要确定基于急诊室的暴力干预计划的最佳实践，并衡量不同环境下社区范围内的有效性。 (C) 2014 年学术急诊医学学会
Objectives: This study intended to explore clients' experiences and provide a contextual basis for understanding their perceptions of the effectiveness of the Boston Medical Center (BMC) Violence Intervention Advocacy Program (VIAP).Methods: This was an exploratory, qualitative study conducted in an urban, Level I trauma center from July 1, 2011, to February 24, 2012. Emergency department (ED) patients older than 18 years with penetrating trauma, and who were enrolled in the VIAP, were eligible. Two trained, qualitative interviewers who were not part of the VIAP obtained consent and conducted in-depth, semistructured interviews. Interviews were audiotaped, transcribed, deidentified, coded, and analyzed. Thematic content analysis consistent with grounded theory was used to identify themes related to client experiences with VIAP, life circumstances, challenges to physical and emotional healing postinjury, services provided by VIAP, and perceptions of VIAP's effectiveness.Results: Twenty subjects were interviewed. Most were male, African American, and younger than 30 years of age, reflecting the overall program's clientele. Most subjects perceived their advocates as caring adults in their lives and cited aspects of the peer support model that helped establish trusting relationships. Major challenges to healing were fear and safety, trust, isolation as a coping mechanism, bitterness, and symptoms of posttraumatic stress disorder (PTSD). Every subject noted important services provided by VIAP advocates. Most subjects explicitly stated that they had positive experiences with the VIAP and perceived advocates' roles as a positive influence, providing client-centered advocacy, education, and support.Conclusions: This study provides insight into the lives of 20 BMC VIAP clients and contextualizes their unique challenges. Participants described positive, life-changing behaviors on their journey to healing through connections to caring, supportive adults. Information gained from this study will help the VIAP to further support its clients. However, future research is needed to identify best practices for ED-based violence intervention programs and to measure community-wide efficacy in different settings. (C) 2014 by the Society for Academic Emergency Medicine