ED Manag. 2015 Oct;27(10):117-9.
Findings from a large, randomized clinical trial suggest that the use of an ED-based motivational intervention is not sufficient to reduce incidents of heavy drinking or intimate partner violence (IPV) among women who present to the ED. Investigators have found that while heavy drinking and incidents of IPV declined in all groups being evaluated, the intervention, which involved a 20- to 30-minute motivational interview by a masters-prepared social worker and a follow-up reinforcement call, did not make a difference in outcomes. Investigators conclude that more comprehensive solutions are needed. Participants for the study were recruited from two urban-area EDs in Philadelphia between January 2011 and December 2014. Patients were randomized to an intervention group or one of two control groups. At one year post-enrollment, nearly half (45%) of all the study participants reported no incidents of IPV in the previous three months, and the researchers found that 22% of all participants were consuming alcohol at safe drinking levels. However, there was no evidence that the intervention influenced outcomes. Investigators recommend EDs set up routine screening to identify IPV and co-occurring psychosocial risk factors, and train social workers and IPV advocates to perform safety assessments and provide referrals for more intensive, evidence-based interventions that are tailored to the patient's needs and goals.
一项大型随机临床试验的结果表明,对于到急诊科就诊的女性,采用基于急诊科的动机性干预措施不足以减少酗酒或亲密伴侣暴力(IPV)事件的发生。研究人员发现,虽然在所有接受评估的组中,酗酒和IPV事件都有所减少,但该干预措施(包括由一名具备硕士学历的社会工作者进行20至30分钟的动机性访谈以及一次后续强化电话)并未对结果产生影响。研究人员得出结论,需要更全面的解决方案。该研究的参与者于2011年1月至2014年12月期间从费城的两家市区急诊科招募。患者被随机分配到干预组或两个对照组之一。在入组一年后,近一半(45%)的研究参与者报告在过去三个月中没有发生IPV事件,研究人员发现22%的参与者饮酒量处于安全水平。然而,没有证据表明该干预措施影响了结果。研究人员建议急诊科开展常规筛查,以识别IPV和同时存在的心理社会风险因素,并培训社会工作者和IPV倡导者进行安全评估,并为根据患者需求和目标量身定制的更强化、基于证据的干预措施提供转诊服务。