Calderón Sophia H, Gilbert Paul, Jackson Rebecca, Kohn Michael A, Gerbert Barbara
Division of Behavioral Sciences, Professionalism, and Ethics, University of California San Francisco, San Francisco, California 94117, USA.
Am J Prev Med. 2008 Feb;34(2):134-7. doi: 10.1016/j.amepre.2007.09.029.
Intimate partner violence (IPV) during pregnancy poses a significant health risk to the mother and developing fetus. Practice guidelines recommend that prenatal providers screen for and counsel their patients about IPV, yet many physicians express reluctance or discomfort regarding such discussions. The Health in Pregnancy (HIP) computer program was designed to improve prenatal providers' counseling about behavioral risks.
English-speaking women 18 years or older, less than 26-weeks pregnant, and receiving prenatal care at one of the five participating clinics in the San Francisco area, were randomized in parallel groups in a controlled trial (June 2006-present; data analyzed June 2007). Participants reporting one or more risks were randomized to intervention or control in stratified blocks. Providers received summary "cueing sheets" alerting them to their patient's risk(s) and suggesting counseling statements.
Thirteen percent (37/286) of the sample reported current IPV. Provider cueing resulted in 85% of the IPV-intervention group reporting discussions with their provider, compared to 23.5% of the control group (p<0.001).
IPV discussions were influenced strongly by cueing providers. Provider cueing is an effective and appropriate adjunct to routine risk counseling in prenatal care.
孕期亲密伴侣暴力（IPV）对母亲和发育中的胎儿构成重大健康风险。实践指南建议产前保健人员对患者进行IPV筛查并提供咨询，但许多医生对这类讨论表示不情愿或感到不适。孕期健康（HIP）计算机程序旨在改善产前保健人员对行为风险的咨询。
年龄在18岁及以上、怀孕少于26周、在旧金山地区五家参与诊所之一接受产前护理的英语女性，在一项对照试验中被随机分为平行组（2006年6月至今；2007年6月分析数据）。报告一项或多项风险的参与者在分层区组中被随机分配到干预组或对照组。医护人员收到总结性“提示单”，提醒他们注意患者的风险并给出咨询建议。
样本中有13%（37/286）报告当前存在IPV。医护人员提示后，IPV干预组中有85%报告与医护人员进行了讨论，而对照组这一比例为23.5%（p<0.001）。
医护人员提示对IPV讨论有很大影响。医护人员提示是产前护理常规风险咨询的有效且合适的辅助手段。
