Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Psychiatr Ment Health Nurs. 2024 Apr;31(2):203-214. doi: 10.1111/jpm.12976. Epub 2023 Sep 12.
WHAT IS KNOWN ON THE SUBJECT?: Women are more likely to experience intimate partner violence (IPV) than men; 19.2%-69.0% of women have experienced IPV, and the percentage is increasing. Survivors of IPV suffer from physical, psychological, social and reproductive health problems and numerous adverse health consequences such as post-traumatic stress disorder, depression and anxiety. These are considered IPV comorbidities, especially among women. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study reviews and reinforces existing scientific knowledge regarding the application of trauma-informed care (TIC), including intervention content or type, frequency, duration of session and length. This study focused on the effects of TIC. Furthermore, it examines short-term (3 months) and medium-term (6 months) outcome effects, which are more significant for clinical practice. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Development of a standardized protocol to address specific needs for TIC in IPV care settings. Among multidisciplinary teams, nurses are the ideal professionals to support women experiencing IPV. They can understand their traumatic experiences better, improve their therapeutic relationships and engage patients in collaborative care.
INTRODUCTION: Post-traumatic stress disorder (PTSD), depression and anxiety are considered intimate partner violence (IPV) comorbidities, especially among women. Trauma-informed care (TIC) is the most common element of IPV care.
This study analysed the short-term (3 months) and medium-term (6 months) outcomes of TIC on PTSD, depression and anxiety in women experiencing IPV.
The Preferred Items for Systematic Reviews and Meta-Analysis guidelines were followed, and databases were searched from their inception to September 2022.
Thirteen randomized controlled trials included 850 women randomly assigned to the TIC and usual care groups. Overall, TIC showed a superior psychological health-improving effect. Depression and anxiety significantly improved after treatment and at three and 6 months. No difference was observed in PTSD between the two groups at 3 and 6 months.
The growing evidence demonstrates that the lack of IPV intervention effects reported by reviews may be due to the attributes of PTSD, heterogeneity of TIC intervention design and components of TIC. Therefore, its clinical efficacy remains inconclusive.
We analysed studies by stratifying intervention frequencies of once or twice a week. Regardless of the intervention frequency, length and design, PTSD decreased immediately after the TIC intervention. However, a significant difference in depression was observed after a TIC intervention of above 9 weeks.
本研究分析了创伤知情护理（TIC）对经历亲密伴侣暴力（IPV）的女性的 PTSD、抑郁和焦虑的短期（3 个月）和中期（6 个月）结局。
本研究遵循系统评价和荟萃分析的首选项目指南，并从成立之初到 2022 年 9 月对数据库进行了搜索。
共纳入 13 项随机对照试验，850 名女性被随机分配到 TIC 组和常规护理组。总体而言，TIC 显示出更好的改善心理健康效果。抑郁和焦虑在治疗后以及 3 个月和 6 个月时均显著改善。3 个月和 6 个月时，两组 PTSD 无差异。
越来越多的证据表明，综述中报道的缺乏 IPV 干预效果可能是由于 PTSD 的属性、TIC 干预设计和 TIC 组成部分的异质性所致。因此，其临床疗效仍不确定。
我们通过分层每周一次或两次的干预频率来分析研究。无论干预频率、长度和设计如何，TIC 干预后 PTSD 立即下降。然而，TIC 干预超过 9 周后，抑郁的差异显著。
