Martin-Engel Lindsay, Allen Jacqueline, Alencar Amber, Levin Scott, Udezi Victoria O, Pagels Patti, Eary Rebecca L
Foremost Family Health Center, Balch Springs, TX.
Charles R. Drew University of Medicine and Science, Los Angeles, CA.
PRiMER. 2021 Jun 18;5:20. doi: 10.22454/PRiMER.2021.717020. eCollection 2021.
Primary care clinicians are in a unique position to address intimate partner violence (IPV) in routine clinical practice. The purpose of this study was to improve clinician readiness to identify and manage IPV in four family medicine residency practice sites on the west side of Chicago by partnering with a local domestic violence organization.
Practice sites included three federally qualified health centers and one hospital-based office. Eligible clinicians included resident and faculty physicians, nurse practitioners, and certified nurse midwives. We assessed readiness using the validated Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS). We used initial survey results (n=53, 73%) to develop a targeted clinician educational intervention by a community organization. We administered the PREMIS tool postintervention at 1 and 6 months, measuring perceived and actual knowledge, preparedness, and practice issues. We performed comparison statistics to assess aggregate change.
PREMIS response rates were n=53 (72%), n=32 (47%), and n=36 (49%), for preintervention, 1, and 6 months postintervention, respectively. Mean clinician preparedness score improved significantly at 1 and 6 months (<.001, <.009). Mean self-perceived knowledge score improved significantly at 1 month (<.001) and trended toward improvement at 6 months (=.07). Actual knowledge trended toward improvement at 1 month (=.07) and after 6 months (=.05). Mean practice issues scores did not improve significantly.
Participation in a 45-minute targeted educational intervention improved clinician readiness to manage IPV. Collaborating with a community partner builds a relationship for further referrals and advocacy for patients.
在日常临床实践中,初级保健临床医生在处理亲密伴侣暴力(IPV)方面具有独特地位。本研究的目的是通过与当地家庭暴力组织合作,提高芝加哥西区四个家庭医学住院医师培训实践点的临床医生识别和处理IPV的准备程度。
实践点包括三个联邦合格健康中心和一个医院门诊。符合条件的临床医生包括住院医师和教职医生、执业护士和认证助产士。我们使用经过验证的《医生处理亲密伴侣暴力准备情况调查问卷》(PREMIS)评估准备程度。我们利用初始调查结果(n = 53,73%)制定了由社区组织开展的针对性临床医生教育干预措施。我们在干预后1个月和6个月使用PREMIS工具进行测量,评估感知和实际知识、准备程度及实践问题。我们进行比较统计以评估总体变化。
PREMIS的回复率在干预前、干预后1个月和6个月分别为n = 53(72%)、n = 32(47%)和n = 36(49%)。临床医生的平均准备程度得分在干预后1个月和6个月显著提高(<.001,<.009)。平均自我感知知识得分在干预后1个月显著提高(<.001),在6个月时呈改善趋势(=.07)。实际知识在干预后1个月呈改善趋势(=.07),6个月后也呈改善趋势(=.05)。平均实践问题得分没有显著改善。
参与45分钟的针对性教育干预提高了临床医生处理IPV的准备程度。与社区合作伙伴合作建立了进一步转诊和为患者进行宣传的关系。