Maiuro R D, Vitaliano P P, Sugg N K, Thompson D C, Rivara F P, Thompson R S
University of Washington School of Medicine, Department of Psychiatry, Seattle, Washington 98104, USA.
Am J Prev Med. 2000 Nov;19(4):245-52. doi: 10.1016/s0749-3797(00)00230-0.
Despite rapid proliferation of descriptive studies of health care providers (HCPs) and protocols for identification and management of domestic violence (DV), few reliable instruments exist for assessing HCPs' attitudes, beliefs, and behaviors regarding this practice. This study describes the development and psychometric properties of a measure of attitudes, beliefs, and self-reported behaviors related to the identification and management of DV.
We used a multiphase study design to develop items across eight content domains. We administered an initial pool of 104 items to a pilot sample of 129 primary care providers (physicians, physician assistants, nurse practitioners, and medical assistants) in a large, urban health maintenance organization. Descriptive statistics, principal components, and reliability analyses were performed on each of the eight content domains. The analyses guided the deletion of items and development of additional items, yielding a 56-item pool. The items were then administered and re-analyzed with an independent sample of 246 HCPs.
Six separate and reliable domains were identified: Perceived Self-Efficacy, System Support, Blame Victim, Professional Role Resistance/Fear of Offending Patient, Victim/Provider Safety, and Frequency of DV Inquiry. We found item domain Cronbach alpha to be acceptable, ranging from 0.73 to 0.91. The final overall measure had 39 items and an alpha of 0.88. Data are reviewed that support the measure's sensitivity to change in response to a training intervention.
The measure provides a reliable method for assessing provider characteristics and training needs. It may also serve to evaluate training and policy interventions in DV.
尽管关于医疗保健提供者（HCPs）以及家庭暴力（DV）识别与管理方案的描述性研究迅速增加，但用于评估HCPs对该行为的态度、信念和行为的可靠工具却很少。本研究描述了一种与DV识别和管理相关的态度、信念及自我报告行为测量方法的开发及心理测量特性。
我们采用多阶段研究设计，在八个内容领域开发项目。我们向一个大型城市健康维护组织中的129名初级保健提供者（医生、医师助理、执业护士和医疗助理）的试点样本发放了最初的104个项目。对八个内容领域中的每一个进行描述性统计、主成分分析和可靠性分析。这些分析指导了项目的删除和额外项目的开发，产生了一个56个项目的题库。然后对246名HCPs的独立样本发放这些项目并重新分析。
确定了六个独立且可靠的领域：感知自我效能、系统支持、责怪受害者、专业角色抵触/害怕冒犯患者、受害者/提供者安全以及DV询问频率。我们发现项目领域的克朗巴哈α系数是可接受的，范围从0.73到0.91。最终的总体测量有39个项目，α系数为0.88。审查了支持该测量对培训干预反应变化敏感性的数据。
该测量提供了一种评估提供者特征和培训需求的可靠方法。它还可用于评估DV方面的培训和政策干预。
