Nicolaidis Christina, Curry MaryAnn, Gerrity Martha
Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
J Gen Intern Med. 2005 Aug;20(8):731-7. doi: 10.1111/j.1525-1497.2005.0141.x.
Most continuing medical education programs on intimate partner violence (IPV) use an expert-driven approach and focus on changing knowledge and screening behaviors. The Voices of Survivors program aims to also improve attitudes and empathy.
To test the Attitudes Toward Survivors of IPV (ATSI) survey psychometrically. To assess the effectiveness of the Voices of Survivors program in changing health care workers' responsibility to assess for and counsel about IPV, respect for patient autonomy, empathy toward patients in abusive relationships, barriers, confidence, knowledge, and self-reported assessment behaviors.
Thirty-one unaffiliated primary care practices in Washington County, Ore.
Comparison of ATSI survey results before and after a two-hour workshop including a 30-minute video and an advocate-led discussion.
Convenience sample of primary care providers, medical support staff, and other clinic employees.
Two hundred and eighty-four health care workers participated in the training. Two hundred and sixty-seven (94%) completed workshop evaluations and 187 (66%) completed both pre- and postintervention surveys. Cronbach's alpha for all scales ranged from 0.68 to 0.92. Postintervention, participants' summary scores improved for responsibility to assess for IPV (3.96 vs 3.64; P<.0001), respect for patient autonomy (2.78 vs 2.41; P<.0001), empathy (3.24 vs. 2.99; P=.002), confidence (2.33 vs 2.07; P<.0001), knowledge (2.08 vs 1.64; P<.0001), and self-reported behaviors (3.08 vs 2.53; P=.0001). Barriers related to availability of resources and referrals also improved.
The ATSI scales demonstrated good internal reliability and responsiveness to change in all domains except responsibility to counsel. The Voices of Survivors documentary, along with a workshop based on its companion guide, improved clinic employees' knowledge, attitudes, empathy, and self-reported assessment behaviors about IPV.
大多数关于亲密伴侣暴力（IPV）的继续医学教育项目采用专家主导的方法，侧重于改变知识和筛查行为。“幸存者之声”项目旨在同时改善态度和同理心。
从心理测量学角度测试亲密伴侣暴力幸存者态度（ATSI）调查。评估“幸存者之声”项目在改变医护人员评估和咨询亲密伴侣暴力的责任、对患者自主权的尊重、对处于虐待关系中的患者的同理心、障碍、信心、知识以及自我报告的评估行为方面的有效性。
俄勒冈州华盛顿县的31家独立初级保健机构。
对包括30分钟视频和倡导者主导讨论的两小时工作坊前后的ATSI调查结果进行比较。
初级保健提供者、医疗支持人员和其他诊所员工的便利样本。
284名医护人员参加了培训。267人（94%）完成了工作坊评估，187人（66%）完成了干预前后的调查。所有量表的克朗巴哈系数在0.68至0.92之间。干预后，参与者在评估亲密伴侣暴力的责任（3.96对3.64；P<0.0001）、对患者自主权的尊重（2.78对2.41；P<0.0001）、同理心（3.24对2.99；P=0.002）、信心（2.33对2.07；P<0.0001）、知识（2.08对1.64；P<0.0001）以及自我报告行为（3.08对2.53；P=0.0001）方面的总分有所提高。与资源和转诊可用性相关的障碍也有所改善。
ATSI量表在除咨询责任外的所有领域都显示出良好的内部信度和对变化的反应性。“幸存者之声”纪录片以及基于其配套指南的工作坊改善了诊所员工关于亲密伴侣暴力的知识、态度、同理心和自我报告的评估行为。
