TREATMENT OUTCOMES FOR ABUSED WOMEN IN PUBLIC CLINICS

受虐待妇女在公共诊所的治疗结果

• 批准号: 6391179
• 负责人: JANET Y GROFF
• 金额: $ 48.68万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 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 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6391179
• 关键词: African American; Hispanic Americans; behavior modification; behavioral /social science research tag; caucasian American; child behavior; clinical research; clinical trials; family structure /dynamics; female; functional ability; group therapy; health care service utilization; health services research tag; human subject; human therapy evaluation; longitudinal human study; managed care; nursing intervention; outcomes research; patient care management; quality of life; self care; social behavior; social support network; spouse abuse; women's health

This 4-year randomized controlled trial will design, implement, and test the efficacy of nurse case management and group education for African- American, Hispanic, and White abused women attending inner city primary care clinics. These clinics are part of a county-wide system that maintains a computerized information system of inpatient and outpatient encounters. The theoretically-based intervention will build on empirically tested components designed to: increase safety planning behaviors; increase self-efficacy for safety behaviors; decrease frequency and severity of abuse; improve physical emotional and social well-being; decrease unscheduled medical care utilization; and increase work productivity. An additional objective is to evaluate the impact of the interventions on the health and functional status and medical utilization of abused women's children. Consecutive sampling of women 18-44 years of age presenting for medical care will be screened for domestic violence until a sample of 400 abused women is obtained. Participants will be randomized to one of 4 treatment cells in a factorial design: referral card, referral card + group education, referral card + case management, referral card + group education + case management. Nurse case management will include education on safety planning, crisis management, supportive care, anticipatory guidance, and referrals. Group education will consist of sessions conducted by local legal, social, and educational agencies for abused women. The factorial study design will allow testing the main effects of group education and nurse case management and the interaction of group education and case management on safety behaviors, health outcomes in the women and their children, and medical care utilization. Measures will be collected at baseline and every 6 months for 3 years after randomization. An economic evaluation of the program will be conducted using cost benefit analyses of the four alternative treatments from both societal and health care system perspectives.

这项为期4年的随机对照试验将设计，实施和测试护士病例管理和小组教育的有效性，为非洲裔美国人，西班牙裔和白色虐待妇女参加内城初级保健诊所。这些诊所是全县系统的一部分，该系统维护住院和门诊就诊的计算机化信息系统。以理论为基础的干预将建立在经验测试的组成部分，旨在：增加安全规划行为;提高安全行为的自我效能;减少虐待的频率和严重程度;改善身体情感和社会福祉;减少计划外的医疗保健利用;提高工作效率。另一个目标是评价干预措施对受虐待妇女子女的健康和功能状况以及医疗利用的影响。将对18至44岁的就医妇女进行对比性抽样，以筛查家庭暴力，直至获得400名受虐待妇女的样本。参与者将被随机分配到析因设计中的4个治疗单元之一：转诊卡，转诊卡+团体教育，转诊卡+病例管理，转诊卡+团体教育+病例管理。护士个案管理将包括安全规划，危机管理，支持性护理，预期指导和转介教育。集体教育将包括由当地法律的、社会和教育机构为受虐待妇女举办的会议。析因研究设计将允许测试组教育和护士个案管理的主要影响，以及组教育和个案管理对安全行为、妇女及其子女的健康结局和医疗保健利用的相互作用。将在基线和随机化后每6个月收集一次测量结果，持续3年。将从社会和卫生保健系统的角度对四种替代治疗方法进行成本效益分析，对该计划进行经济评估。