A RCT OF COMPUTER SCREENING FOR DOMESTIC VIOLENCE

家庭暴力计算机筛查随机对照试验

• 批准号: 6312053
• 负责人: WENDY LEVINSON
• 金额: $ 32.83万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6312053
• 关键词: African American; audiotape; behavioral /social science research tag; caucasian American; clinical research; clinical trials; computer assisted diagnosis; emergency health services; health care service; health care service evaluation; health services research tag; health surveys; human subject; interview; nursing intervention; outcomes research; patient care management; questionnaires; spouse abuse; statistics /biometry; violence; women's health

Victims of domestic violence frequently seek medical care in emergency departments (EDs) and health care providers have the opportunity to detect DV and intervene. Unfortunately ED personnel often do not screen for DV due to time pressures and the sensitive nature of the problem. Novel methods are needed to improve detection and intervention in the ED. We developed and piloted a self-administered computer health risk assessment (ED Prevent) that is completed by patients before their ED visit. High-risk behaviors are provided to the ED physician. Our pilot demonstrated significant improvement in the chart documentation of DV by physicians in patients receiving ED Prevent (19 chart notes of DV) compared to controls (1 chart note).This study is a randomized control trial to test the effect of ED Prevent on the communication between physicians/nurses and patients about DV. 800 women patients presenting to two different EDs (a urban ED with largely African American patients and a suburban community ED with mainly Caucasian patients) will be randomized to either ED Prevent or Usual Care. All visits will be audio-taped. Primary outcomes for the study will be patient disclosure and physician/nurse discussion of DV based on the audio-tapes. Secondary outcomes will include patient knowledge of, or contact with, DV services, patient satisfaction with communication with ED staff, and chart documentation of DV. The effect of ED Prevent on rates of disclosure and discussion will be evaluated using logistic regression controlling for hospital site and patient demographics. In addition a qualitative analysis will explore the effect of ED Prevent on DV communication variables [such as the timing and initiation of discussions about DV and ED provider/patient affective responses] The study has the potential to provide a novel way to screen women in the ED relying on a computer instead of a busy physician and potentially shifting the role of the physician to discussion and referral, ultimately improving the likelihood that women will change the abusive situation. The study results may be generalizable to many other EDs with a variety of populations. Further the data will be available for future investigations of communication in the ED.

家庭暴力受害者经常到急诊室寻求医疗护理，卫生保健提供者有机会发现家庭暴力并进行干预。不幸的是，由于时间压力和问题的敏感性，艾德人员通常不筛查DV。需要新的方法来提高检测和干预的ED。我们开发和试行了一个自我管理的计算机健康风险评估（艾德预防），是由患者完成之前，他们的艾德访问。向艾德医生提供高风险行为。我们的试点证明，在接受艾德预防的患者中，医生记录DV的图表记录（19个DV图表注释）与对照组（1个图表注释）相比有显著改善。本研究是一项随机对照试验，旨在测试艾德预防对医生/护士与患者之间关于DV的沟通的影响。接受两种不同ED治疗的800例女性患者（主要为非裔美国人患者的城市艾德和主要为白人患者的郊区社区艾德）将被随机分配至艾德预防治疗组或家庭护理组。所有访问都将录音。本研究的主要结局将是基于录音带的DV患者披露和医生/护士讨论。次要结局将包括患者对DV服务的了解或接触、患者对与艾德工作人员沟通的满意度以及DV图表记录。将使用logistic回归控制医院研究中心和患者人口统计学，评价艾德预防对披露率和讨论率的影响。此外，定性分析将探索艾德预防对DV沟通变量的影响[例如关于DV和艾德提供者/患者情感反应的讨论的时间和开始]该研究有可能提供一种新的方法来筛选艾德中的女性，依赖于计算机而不是忙碌医生，并可能将医生的角色转移到讨论和转诊，最终提高妇女改变虐待状况的可能性。研究结果可推广到许多其他ED的各种人群。此外，这些数据将可用于ED中未来的通信调查。