Identification and management of domestic violence: a randomized trial.
Identification and management of domestic violence: a randomized trial.
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家庭暴力的识别和管理：一项随机试验。
DOI：
10.1016/s0749-3797(00)00231-2
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发表时间：
2000
影响因子：
5.5
通讯作者：
Rubanowice,DM
中科院分区：
文献类型：
--
作者：
Thompson,RS;Rivara,FP;Thompson,DC;Barlow,WE;Sugg,NK;Maiuro,RD;Rubanowice,DM
家庭暴力(DV)在初级保健中的诊断率与其流行率相比很低。对病人的照顾是不够的。在一年的时间里，我们测试了强化干预的有效性，以改善对DV的询问、病例发现和初级保健中的管理。干预措施包括对提供者的技能培训、环境协调(临床区域海报、DV健康问卷问题)、测量和反馈。方法在某大型卫生维护组织(HMO)的5个初级保健诊所进行团体随机对照试验。结果在干预开始后的9个月和21个月(除了感知到的询问之外)记录了提供者自我效能的改善、对冒犯的恐惧和安全担忧的减少以及对DV的感知询问的增加。记录在案的询问DV的人在9个月时比对照组增加了14.3%，相对增加了3.9倍。病例发现率增加1.3倍(95%，可信区间0.67~2.7)。结论干预后9个月记录的询问DV的情况有所改善。这主要是由于在体检时例行使用包含DV问题的健康问卷，以及在临床地区放置DV海报。病例发现率也略有增加。系统改变似乎是增加DV询问和识别的一种经济有效的方法。
BackgroundDiagnosis of domestic violence (DV) in primary care is low compared to its prevalence. Care for patients is deficient. Over a 1-year period, we tested the effectiveness of an intensive intervention to improve asking about DV, case finding, and management in primary care. The intervention included skill training for providers, environmental orchestration (posters in clinical areas, DV questions on health questionnaires), and measurement and feedback.MethodsWe conducted a group-randomized controlled trial in five primary care clinics of a large health maintenance organization (HMO). Outcomes were assessed at baseline and follow-up by survey, medical record review, and qualitative means.ResultsImproved provider self-efficacy, decreased fear of offense and safety concerns, and increased perceived asking about DV were documented at 9 months, and also at 21 months (except for perceived asking) after intervention initiation. Documented asking about DV was increased by 14.3% with a 3.9-fold relative increase at 9 months in intervention clinics compared to controls. Case finding increased 1.3-fold (95%, confidence interval 0.67–2.7).ConclusionsThe intervention improved documented asking about DV in practice up to 9 months later. This was mainly because of the routine use of health questionnaires containing DV questions at physical examination visits and the placement of DV posters in clinical areas. A small increase in case finding also resulted. System changes appear to be a cost-effective method to increase DV asking and identification.
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影响因子：
4.4
作者：
Campbell, JC;Coben, JH;Durborow, N
通讯作者：
Durborow, N
社区实践中家庭暴力的发生率和医生询问率。
影响因子：
1.9
作者：
Hamberger Lk;D. Saunders;M. Hovey
通讯作者：
M. Hovey
提高急诊医生对家庭暴力的认识。
影响因子：
6.2
作者：
L. Olson;Carolyn Anctil;L. Fullerton;J. Brillman;Justin Arbuckle;D. Sklar
通讯作者：
D. Sklar
WomanKind：针对家庭虐待的医疗保健应对创新模式。
DOI：
10.1016/1049-3867(95)00055-0
发表时间：
1995
期刊：
Women's health issues : official publication of the Jacobs Institute of Women's Health
影响因子：
--
作者：
S. Hadley;L. Short;N. Lezin;E. Zook
通讯作者：
E. Zook
影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM