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组织因素对高校医疗保健提供者进行亲密伴侣暴力和性暴力筛查实践的影响。

Organizational influences on the intimate partner violence and sexual violence screening practices of college health care providers.

机构信息

Decker School of Nursing, Binghamton University, State University of New York, Binghamton, New York.

College of Nursing, University of Rhode Island, Providence, Rhode Island.

出版信息

Res Nurs Health. 2019 Aug;42(4):284-295. doi: 10.1002/nur.21950. Epub 2019 May 13.

Abstract

Experts and professional organizations in the U.S. have issued recommendations that health care providers (HCPs) should screen women for intimate partner violence (IPV) and sexual violence (SV). Despite the high rates of IPV and SV experienced by female college students, investigators have found that providers are not screening for IPV and SV in college health centers. In this study, a cross-sectional survey design was utilized to: (a) examine college HCPs' reports of IPV/SV screening behaviors and (b) identify the individual-level and organization-level structure and process characteristics that promote or inhibit IPV/SV screening. A total of 773 college HCPs (physicians, nurse practitioners, and registered nurses) were invited to participate in the study using two separate sampling frames. The final sample included 210 college HCPs. Providers reported low rates of IPV/SV screening (median = 20%). Screening rates varied by provider type with nurse practitioners reporting the highest screening rates. Urban location was associated with a three and one-half times greater likelihood of IPV/SV screening. Use of an electronic health record that included a prompt to screen was associated with a three-fold increase in the likelihood that HCPs would screen for IPV/SV. Further study is needed to better understand how organizational factors influence providers' screening behaviors in college health centers and how these influences are mediated. Future studies should include larger and more diverse samples of colleges and examine geographical variations in screening practices.

摘要

美国的专家和专业组织已经发布了建议,即医疗保健提供者(HCPs)应该对女性进行亲密伴侣暴力(IPV)和性暴力(SV)的筛查。尽管女大学生经历了很高的 IPV 和 SV 发生率,但调查人员发现,提供者在大学健康中心没有对 IPV 和 SV 进行筛查。在这项研究中,采用了横断面调查设计:(a)检查大学 HCPs 报告的 IPV/SV 筛查行为;(b)确定促进或抑制 IPV/SV 筛查的个体和组织层面的结构和流程特征。总共邀请了 773 名大学 HCPs(医生、护士从业者和注册护士)使用两个单独的抽样框架参与研究。最终样本包括 210 名大学 HCPs。提供者报告的 IPV/SV 筛查率较低(中位数=20%)。筛查率因提供者类型而异,护士从业者的筛查率最高。城市地理位置与 IPV/SV 筛查的可能性增加了三倍半有关。使用包括筛查提示的电子健康记录与 HCP 筛查 IPV/SV 的可能性增加三倍有关。需要进一步研究以更好地了解组织因素如何影响大学健康中心提供者的筛查行为,以及这些影响是如何被中介的。未来的研究应包括更大和更多样化的大学样本,并研究筛查实践在地理上的差异。

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