Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.
Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.
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儿童医院的亲密伴侣暴力项目：利用德尔福仪器进行综合评估。
DOI：
10.1542/hpeds.2014-0054
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发表时间：
2015
影响因子：
--
通讯作者：
M. Dowd
中科院分区：
文献类型：
--
作者：
K. Randell;S. E. Evans;Donna O’Malley;M. Dowd
目的
本研究的目的是进行基线评估的亲密伴侣暴力（IPV）的做法在儿科医院系统。
方法
德尔菲工具，以医院为基础的家庭暴力方案被用来评估医院系统的IPV做法的结构和组成部分。通过与主要利益相关者的访谈，我们还评估了个别患者护理领域的IPV实践。访谈数据的定性分析采用扎根理论方法。
结果
医院在德尔菲仪器评估中得到17分。德尔菲工具和访谈确定的关键薄弱领域包括缺乏协调的供应商培训和评估IPV相关流程，没有标准的IPV筛选，安全评估和文件。大多数受访者支持解决IPV问题;所有受访者都确定了在个人提供者和机构层面进行IPV筛查的障碍。制度障碍包括缺乏对IPV披露的标准化反应，需要为不同的患者护理环境制定个性化的筛查方案，缺乏标准化的提供者培训，对过度扩展社会工作资源的担忧，以及缺乏经历替代性创伤的医院工作人员的资源。个人障碍包括担心筛查可能会损害医生-患者-家庭关系，以及认为医生不愿意解决心理社会问题。
结论
德尔菲医院家庭暴力方案工具确定了家庭暴力预防做法的弱点和需要改进的关键领域。个体访谈结果证实了德尔菲法所揭示的缺陷。必须解决机构和个人提供者层面的障碍，以优化儿科医院系统的IPV实践。
OBJECTIVE
The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system.
METHODS
The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach.
RESULTS
The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues.
CONCLUSIONS
The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system.