An evaluation of a system-change training model to improve emergency department response to battered women
An evaluation of a system-change training model to improve emergency department response to battered women
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DOI：
10.1111/j.1553-2712.2001.tb01277.x
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发表时间：
2001-02-01
影响因子：
4.4
通讯作者：
Durborow, N
中科院分区：
文献类型：
--
作者：
Campbell, JC;Coben, JH;Durborow, N
目的：评估家庭暴力预防基金和宾夕法尼亚州反家庭暴力联盟为提高急诊科（艾德）应对亲密伴侣暴力（IPV）的有效性而提供的系统变革培训模式。方法：一项实验设计，在基线、干预后9-12个月和18-24个月测量结果。随机选择宾夕法尼亚州和加州的12家医院，每年有20，000 - 40，000例艾德就诊，并随机分配到实验和对照条件下。来自每个实验医院的急诊科团队（医生，护士，社会工作者）和当地的家庭暴力倡导者参加了为期两天的教学信息和团队规划干预。结果如下：干预后，实验医院在员工知识和态度测量（F = 5.57，p = 0.019）、“艾德文化”系统变化指标的所有组成部分（F = 5.72，p = 0.04）和患者满意度（F = 15.43，p < 0.001）方面均显著高于对照医院。在实验医院和对照医院的病历中，受虐妇女的识别率没有显著差异（F = 0.411，p = 0.52）（尽管线性比较是在预期的方向上）。结论：IPV艾德培训的系统变革模式有效地改善了工作人员对受虐妇女的态度和知识，并在协议和工作人员的培训，以及病人的信息和满意度。然而，实际临床实践的变化更难实现，可能会受到机构政策的影响。
Objectives: To evaluate a system-change model of training from the Family Violence Prevention Fund and the Pennsylvania Coalition Against Domestic Violence for improving the effectiveness of emergency department (ED) response to intimate partner violence (IPV). Methods: An experimental design with outcomes measured at baseline, 9-12, and 18-24 months post-intervention. Twelve hospitals in Pennsylvania and California with 20,000-40,000 annual ED visits were randomly selected and randomly assigned to experimental and control conditions. Emergency department teams (physician, nurse, social worker) from each experimental hospital and a local domestic violence advocate participated in a two-day didactic information and team planning intervention. Results: The experimental hospitals were significantly higher than the control hospitals on a staff knowledge and attitude measure (F = 5.57, p = 0.019), on all components of the "culture of the ED" system-change indicator (F = 5.72, p = 0.04), and in patient satisfaction (F = 15.43, p < 0.001) after the intervention. There was no significant difference in the identification rates of battered women (F = 0.411, p = 0.52) (although the linear comparison was in the expected direction) in the medical records of the experimental and control hospitals. Conclusions: A system-change model of IPV ED training was effective in improving staff attitudes and knowledge about battered women and in protocols and staff training, as well as patient information and satisfaction. However, change in actual clinical practice was more difficult to achieve and may be influenced by institutional policy.