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利用社区参与式研究为抑郁和疼痛的亲密伴侣暴力受害者开发创新的治疗模式。

Development of an Innovative Treatment Paradigm for Intimate Partner Violence Victims With Depression and Pain Using Community-Based Participatory Research.

机构信息

1 University of Rochester, NY, USA.

2 SUNY Buffalo State College, NY, USA.

出版信息

J Interpers Violence. 2018 Sep;33(17):2704-2724. doi: 10.1177/0886260516628810. Epub 2016 Feb 12.

Abstract

Intimate partner violence (IPV) is a public health issue with complex physical health, mental health and social consequences that can exacerbate survivors' barriers to health care engagement and support. Furthermore, health care professionals are often unaware of or feel ill-equipped to address survivors' complex needs. Depression and chronic pain are particularly prevalent co-occurring problems for survivors and can impede engagement and outcomes in traditional health care. This study's purpose was to understand what interventions might be more responsive to survivors' myriad needs, particularlly those with depression and pain. Survivors were involved with the design, execution, analysis, and interpretation of results, based on community-based participatory research principles. Intervention development happened in two phases: the first consisted of focus groups with survivors to inform the intervention and the second included intervention design, informed by a community advisory board (CAB). Thirty-one survivors participated in Phase 1, and they reported preferring a range of support including formal help-seeking, informal coping strategies, and spirituality. In Phase 2, the CAB (comprised of survivors, health care professionals, and researchers) identified three distinct aspects of a comprehensive IPV intervention: (a) education regarding both the complex health issues and available local resources; (b) an integrated consultation service for providers to seek recommendations for responding to the full spectrum of survivors' needs; and (c) a trauma-informed, accessible clinic. Academic medical centers could not have designed this intervention in isolation; survivors and providers played an integral part of this process, and continue to inform our current work.

摘要

亲密伴侣暴力 (IPV) 是一个公共卫生问题,具有复杂的身体健康、心理健康和社会后果,会加剧幸存者获得医疗保健的障碍和支持。此外,医疗保健专业人员通常对幸存者的复杂需求缺乏了解或感到无力应对。抑郁和慢性疼痛是幸存者特别常见的共病问题,会阻碍他们在传统医疗保健中的参与和结果。本研究的目的是了解哪些干预措施可能更能满足幸存者的多种需求,特别是那些有抑郁和疼痛的幸存者。根据社区参与式研究原则,幸存者参与了设计、执行、分析和结果解释。干预措施的制定分两个阶段进行:第一阶段是对幸存者进行焦点小组讨论,以了解干预措施;第二阶段包括干预措施的设计,由社区咨询委员会(CAB)提供信息。31 名幸存者参加了第一阶段,他们报告说更喜欢一系列支持,包括正式寻求帮助、非正式应对策略和精神支持。在第二阶段,CAB(由幸存者、医疗保健专业人员和研究人员组成)确定了一个综合 IPV 干预措施的三个不同方面:(a) 关于复杂健康问题和可用当地资源的教育;(b) 为提供者提供综合咨询服务,以寻求针对幸存者各种需求的建议;(c) 提供一个以创伤为中心、便于获得的诊所。学术医疗中心不可能孤立地设计这种干预措施;幸存者和提供者在这个过程中发挥了不可或缺的作用,并继续为我们当前的工作提供信息。

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