Ernst Amy A, Weiss Steven J, Hobley Kenlyn, Medoro Ian, Baker Joe Jebb, Kanter Julie
University of New Mexico, Department of Emergency Medicine, Albuquerque, NM 87131, USA.
South Med J. 2011 Jun;104(6):446-55. doi: 10.1097/SMJ.0b013e3182186fc3.
To compare two brief randomized computer-based interventions about perpetration of intimate partner violence (IPV).
The study was a prospective cross-sectional cohort study of patients during randomized 4-hour shifts in an urban hospital-based emergency department setting with an emergency medicine residency. The site is a level 1 trauma center emergency department with an annual census of 60,000 adults. A touch-screen computer program was developed in Visual Basic 2005 Studio with consecutive data entry screens. A series of questions to evaluative IPV knowledge, attitude, and practices (KAP) was given before and after the brief intervention. The subjects were randomized to one of two intervention groups. Both groups were shown a set of PowerPoint slides addressing IPV prevention, which was followed by either a control group with nothing further (control) or a five-minute simulation video depicting IPV perpetration in adults (SIM). The main outcome was the net improvement in KAP scores defined as number who improved minus number who did worse. Perpetrators and victims were assessed separately. Demographics were also obtained. For demographics, descriptive statistics and percentages were used. Wilcoxon signed rank test was used for pre-post test paired data.
A total of 239 patients, presenting during 52 randomized four-hour shifts, completed the study; 118 were in the control group, 121 in SIM; 115 (48%) were male and 124 (51 %) female (9 unknown). Most participants were from 21 to 30 years old (38%); 77 (32%) were Hispanic and 100 (42%) were white. There was an overall improvement in responses to KAP questions with correct answers to all questions in 46% before vs 59% after the computer intervention (Diff 13% 95% confidence interval [CI] 4-22). The net improvement in KAP score in the control group was 8% and in the SIM group it was 22% (Diff = 15%, 95% CI = 6-24). Forty subjects (17%, 95% CI = 12-21) were perpetrators and 52 subjects (22%, 95% CI = 17-27) were victims. KAP scores were not significantly improved in the SIM group over the control for either perpetrators or victims.
An IPV simulation video resulted in a greater percent of subjects showing improvement in knowledge, attitudes, and practices about IPV perpetration. A brief IPV simulation video intervention can be performed in a busy emergency department setting.
比较两种关于亲密伴侣暴力（IPV）实施情况的简短随机计算机辅助干预措施。
本研究是一项前瞻性横断面队列研究，研究对象为一家设有急诊医学住院医师培训项目的城市医院急诊科随机4小时轮班期间的患者。该场所是一家一级创伤中心急诊科，年接诊成年患者60000人次。使用Visual Basic 2005 Studio开发了一个触摸屏计算机程序，带有连续的数据输入屏幕。在简短干预前后给出了一系列评估IPV知识、态度和行为（KAP）的问题。受试者被随机分为两个干预组之一。两组都观看了一组关于IPV预防的PowerPoint幻灯片，随后，对照组不再接受进一步干预（对照组），或观看一段五分钟的模拟视频，视频描绘了成年人中的IPV实施情况（模拟组）。主要结局是KAP得分的净改善，定义为得分提高的人数减去得分降低的人数。对施暴者和受害者分别进行评估。还获取了人口统计学数据。对于人口统计学数据，使用描述性统计和百分比。Wilcoxon符号秩检验用于前后测试的配对数据。
共有239名患者在52个随机4小时轮班期间就诊并完成了研究；118人在对照组，121人在模拟组；115人（48%）为男性，124人（51%）为女性（9人情况不明）。大多数参与者年龄在21至30岁之间（38%）；77人（32%）为西班牙裔，100人（42%）为白人。计算机干预前，对KAP问题回答正确的总体比例为46%，干预后为59%（差异13%，95%置信区间[CI]4 - 22）。对照组KAP得分的净改善为8%，模拟组为22%（差异 = 15%，95%CI = 6 - 24）。40名受试者（17%，95%CI = 12 - 21）为施暴者，52名受试者（22%，95%CI = 17 - 27）为受害者。对于施暴者或受害者，模拟组的KAP得分相比对照组均未显著提高。
一段IPV模拟视频使更多受试者在关于IPV实施的知识、态度和行为方面有所改善。简短的IPV模拟视频干预可在繁忙的急诊科环境中进行。
