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迈向亲密伴侣暴力康复之路:阐明以患者为中心的结局,优化针对女性的简短咨询干预。

Strides Toward Recovery From Intimate Partner Violence: Elucidating Patient-Centered Outcomes to Optimize a Brief Counseling Intervention for Women.

机构信息

Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.

VA Center for Health Equity Research and Promotion, Crescenz VA Medical Center, Philadelphia, PA, USA.

出版信息

J Interpers Violence. 2021 Aug;36(15-16):NP8431-NP8453. doi: 10.1177/0886260519840408. Epub 2019 Apr 17.

Abstract

Women in the United States continue to experience intimate partner violence (IPV) at unprecedented rates, necessitating the development and implementation of personalized, effective healthcare-based interventions. Methods of developing patient-centered interventions for IPV should elicit the voice of the target population (i.e., women who experience IPV) while assuring that outcomes identified as important are incorporated into the refined intervention. This pilot study is part of a multiphase, larger study aiming to refine an IPV intervention and clinical outcome measurements prior to formal evaluation of the effectiveness of the intervention. Specifically, this study elucidates patient-centered outcomes identified by women who have experienced IPV. Women patients of the Veterans Health Administration (VHA) in New England participated in focus groups to provide feedback and desired outcomes of a new IPV intervention. Patient-centered outcomes were defined by the participants. Focus groups were transcribed and analyzed using conventional content analysis and matrix analysis. A total of 25 women participated in focus groups ( = 5) at two large VHA facilities. Participant feedback revealed five common themes related to desired outcomes. Women opined increased feelings of empowerment as a key outcome of engaging in an IPV intervention. Women desired increased social connectedness and support to be gained during treatment, citing providers and other survivors of IPV as exemplary sources. Self-esteem was viewed as critical to enhancing recovery, as was increased knowledge across domains of IPV (e.g., warning signs, the link between mental and physical health for self and children). Finally, women identified valued action and goal setting, such as achieving more independence, as an optimal outcome. Addressing IPV against women requires patient-centered interventions that specifically target the types of outcomes deemed important by the end users: women who experience IPV. Findings have implications for tailoring treatments for IPV and selecting measures that tap into women's desired outcomes.

摘要

美国女性继续以前所未有的比率经历亲密伴侣暴力(IPV),这需要制定和实施个性化、有效的基于医疗保健的干预措施。为 IPV 制定以患者为中心的干预措施的方法应该听取目标人群(即经历 IPV 的女性)的意见,同时确保将被确定为重要的结果纳入到改进的干预措施中。这项试点研究是一个多阶段、更大规模研究的一部分,旨在在正式评估干预措施的有效性之前,改进 IPV 干预措施和临床结果测量。具体来说,这项研究阐明了经历过 IPV 的女性确定的以患者为中心的结果。新英格兰退伍军人健康管理局(VHA)的女性患者参加了焦点小组,为新的 IPV 干预措施提供反馈和期望的结果。以患者为中心的结果由参与者定义。使用常规内容分析和矩阵分析对焦点小组进行转录和分析。共有 25 名女性在两个大型 VHA 设施参加了焦点小组(=5)。参与者的反馈揭示了与期望结果相关的五个共同主题。女性认为参与 IPV 干预的关键结果是增强权力感。女性希望在治疗过程中获得更多的社会联系和支持,将提供者和其他 IPV 幸存者视为榜样来源。自尊被视为增强康复的关键,跨 IPV 领域(例如,警告信号、身心健康之间的联系)增加知识也是如此。最后,女性确定了有价值的行动和目标设定,例如实现更多的独立性,这是一个最佳结果。解决针对女性的 IPV 需要以患者为中心的干预措施,这些干预措施专门针对最终用户认为重要的结果类型:经历 IPV 的女性。这些发现对为 IPV 量身定制治疗和选择能够挖掘女性期望结果的措施具有启示意义。

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