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医疗机构中亲密伴侣暴力筛查方案的探索:一项定性研究

An exploration of screening protocols for intimate partner violence in healthcare facilities: a qualitative study.

作者信息

Williams Jessica R, Halstead Valerie, Salani Deborah, Koermer Natasha

机构信息

University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA.

出版信息

J Clin Nurs. 2017 Aug;26(15-16):2192-2201. doi: 10.1111/jocn.13353. Epub 2016 Aug 9.

Abstract

AIMS AND OBJECTIVES

Explore different methods by which intimate partner violence screening practices are implemented in clinic and emergency settings and better understand barriers and facilitators.

BACKGROUND

Healthcare visits provide an opportunity for providers to identify and provide assistance to victims of intimate partner violence. However, wide variation exists in the implementation of screening and response protocols. In addition, providers experience barriers and facilitators to intimate partner violence screening and response. A comprehensive understanding of these factors is necessary to improve the role that providers play in detection and intervention of intimate partner violence.

DESIGN

Qualitative descriptive research design.

METHODS

Sixteen healthcare facilities were recruited from a large metropolitan area in the USA. Data were collected through semi-structured, in-depth interviews with individuals knowledgeable about intimate partner violence screening and response within their facility. Data were analysed using directive content analysis.

RESULTS

Major themes and patterns concerning intimate partner violence screening and response were identified within the following areas: procedural characteristics, barriers, facilitators and additional needs. Patient-provider communication and operational/facility characteristics emerged as critical aspects that impact the successful implementation of intimate partner violence screening and response programmes. Differences were found between clinic and emergency settings stemming from variations in health delivery models.

CONCLUSIONS

Results provide important information on how healthcare facilities implement intimate partner violence screening and response, suggestions for practice improvement and directions for future interventions. Additional guidance is needed to ensure intimate partner violence identification, and response procedures are effective and tailored to needs of patients, providers and the facility.

RELEVANCE TO CLINICAL PRACTICE

Nurses are in a strategic position to play a pivotal role in identification of and response to intimate partner violence. It is essential that nurses are cognizant of this, and understand the actions they can take to assist patients who have been victims of intimate partner violence. Recommendations on how to do this are provided.

摘要

目的

探索在诊所和急诊环境中实施亲密伴侣暴力筛查实践的不同方法,并更好地理解障碍因素和促进因素。

背景

医疗就诊为医疗服务提供者识别亲密伴侣暴力受害者并提供援助提供了机会。然而,筛查和应对方案的实施存在很大差异。此外,医疗服务提供者在亲密伴侣暴力筛查和应对方面面临障碍和促进因素。全面了解这些因素对于改善医疗服务提供者在亲密伴侣暴力检测和干预中所起的作用至关重要。

设计

定性描述性研究设计。

方法

从美国一个大城市地区招募了16家医疗机构。通过对了解其所在机构亲密伴侣暴力筛查和应对情况的人员进行半结构化深度访谈来收集数据。使用定向内容分析法对数据进行分析。

结果

在以下领域确定了有关亲密伴侣暴力筛查和应对的主要主题和模式:程序特征、障碍、促进因素和其他需求。患者与医疗服务提供者的沟通以及运营/机构特征成为影响亲密伴侣暴力筛查和应对方案成功实施的关键方面。由于医疗服务模式的差异,诊所和急诊环境之间存在差异。

结论

研究结果提供了有关医疗机构如何实施亲密伴侣暴力筛查和应对的重要信息、实践改进建议以及未来干预方向。需要额外的指导以确保亲密伴侣暴力的识别以及应对程序有效且符合患者、医疗服务提供者和机构的需求。

与临床实践的相关性

护士在识别和应对亲密伴侣暴力方面处于关键地位,能够发挥重要作用。护士必须认识到这一点,并了解他们可以采取哪些行动来帮助亲密伴侣暴力受害者。文中提供了如何做到这一点的建议。

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