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.

家庭暴力的受害者经常到急诊科 (ED) 寻求医疗护理，而医疗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，急诊室人员通常不会筛查 DV。需要新的方法来改善急诊室的检测和干预。我们开发并试行了自我管理的计算机健康风险评估（ED Prevent），由患者在急诊就诊之前完成。高风险行为会提供给急诊医生。我们的试点表明，与对照组（1 个图表注释）相比，接受 ED Prevent 治疗的患者的医生记录的 DV 图表记录（19 个 DV 图表注释）有显着改善。本研究是一项随机对照试验，旨在测试 ED Prevent 对医生/护士和患者之间有关 DV 的沟通的影响。 800 名女性患者就诊于两个不同的急诊室（一个主要是非裔美国患者的城市急诊室和一个主要是白种人患者的郊区社区急诊室）将被随机分配到急诊预防室或常规护理室。所有访问都将被录音。该研究的主要结果将是患者披露以及医生/护士根据录音带对 DV 进行讨论。次要结果将包括患者对 DV 服务的了解或接触情况、患者对与 ED 工作人员沟通的满意度以及 DV 的图表记录。将使用控制医院地点和患者人口统计数据的逻辑回归来评估 ED Prevent 对披露和讨论率的影响。此外，定性分析将探讨 ED Prevent 对 DV 沟通变量的影响 [例如关于 DV 和 ED 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查 ED 中的女性，依靠计算机而不是忙碌的医生，并可能将医生的角色转移到讨论和转诊，最终提高女性改变虐待状况的可能性。该研究结果可以推广到许多其他不同人群的急诊科。此外，这些数据将可用于急诊室未来的通讯调查。