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遭受亲密伴侣暴力的孕妇的电子健康心理干预(eIPV):一项试点随机对照试验的方案。

E-health psychological intervention in pregnant women exposed to intimate partner violence (eIPV): A protocol for a pilot randomised controlled trial.

机构信息

Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.

Department of Forensic Medicine, University of Malaga, Málaga, Spain.

出版信息

PLoS One. 2023 Mar 17;18(3):e0282997. doi: 10.1371/journal.pone.0282997. eCollection 2023.

Abstract

Intimate partner violence (IPV) during pregnancy, a condition as common as obstetrics conditions like gestational diabetes, is associated with maternal and neonatal complications. Systematic detection of IPV is not well established in antenatal screening probably because the effectiveness of protective interventions has not been evaluated. E-health interventions may be beneficial among mothers exposed to IPV. Prior to performing a full-scale effectiveness trial for such an intervention, a pilot study is required to assess the feasibility of randomising a sufficiently large number of women exposed to IPV during pregnancy. The eIPV trial is a randomised pilot study nested within a cohort of consenting mothers who screen positive for IPV in the first antenatal visit at <12 weeks' gestation and accept an e-health package (psychological counselling by videoconference) in Spain and Denmark. Twenty eligible mothers from the above cohort will be randomised to either intervention or control. The intervention group will receive the e-health package as part of the cohort. The control group will be invited to accept a delay in the intervention (e-health package eight weeks later). After consenting to delay, the control group will provide comparative data without losing the opportunity of obtaining the intervention. We will determine estimates of rates of informed consent to randomization, and the rates of adherence and dropout following randomization. Qualitative interviews will be conducted to examine the women's perception about the benefit of the intervention, reasons for acceptability and non-adherence, and obstacles to recruitment, randomisation and consent. The results will inform the trial feasibility and variance of key clinical outcome measures for estimation of sample size of the full-scale effectiveness trial.

摘要

怀孕期间的亲密伴侣暴力 (IPV) 与母体和新生儿并发症有关,这种情况与妊娠糖尿病等产科情况一样常见。在产前筛查中,尚未很好地确立对 IPV 的系统检测,可能是因为尚未评估保护干预措施的有效性。电子健康干预措施可能对遭受 IPV 的母亲有益。在对这种干预措施进行全面的有效性试验之前,需要进行试点研究,以评估在怀孕期间暴露于 IPV 的足够数量的妇女进行随机分组的可行性。eIPV 试验是一项随机试点研究,嵌套在一个同意参加的母亲队列中,这些母亲在妊娠 12 周前的第一次产前检查中筛查出 IPV 阳性,并在西班牙和丹麦接受电子健康套餐(通过视频会议进行心理咨询)。上述队列中的 20 名符合条件的母亲将被随机分配到干预组或对照组。干预组将接受电子健康套餐作为队列的一部分。对照组将被邀请延迟接受干预(八周后接受电子健康套餐)。在同意延迟后,对照组将提供比较数据,而不会失去获得干预的机会。我们将确定知情同意随机分组的估计率,以及随机分组后的依从性和脱落率。将进行定性访谈,以检查妇女对干预的益处、可接受性和不依从的原因,以及对招募、随机分组和同意的障碍的看法。结果将为试验可行性和关键临床结局测量的变异性提供信息,以便估计全面有效性试验的样本量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0a3/10022801/dc40f2128b28/pone.0282997.g001.jpg

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