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围产期亲密伴侣暴力的干预措施:一项范围综述:一项系统综述

Interventions for intimate partner violence during the perinatal period: A scoping review: A systematic review.

作者信息

Mercier Olivia, Fu Sarah Yu, Filler Rachel, Leclerc Alexie, Sampsel Kari, Fournier Karine, Walker Mark, Wen Shi Wu, Muldoon Katherine

机构信息

Faculty of Medicine University of Ottawa Ottawa Ontario Canada.

Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada.

出版信息

Campbell Syst Rev. 2024 Jul 15;20(3):e1423. doi: 10.1002/cl2.1423. eCollection 2024 Sep.

Abstract

BACKGROUND

Intimate partner violence (IPV) is a prevalent global health problem. IPV that occurs before pregnancy often continues during the perinatal period, resulting in ongoing violence and many adverse maternal, obstetrical, and neonatal outcomes.

OBJECTIVES

This scoping review is designed to broadly capture all potential interventions for perinatal IPV and describe their core components and measured outcomes.

SEARCH METHODS

We conducted a search for empirical studies describing IPV interventions in the perinatal population in June 2022. The search was conducted in MEDLINE, EMBASE, PsycInfo, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, Applied Social Sciences Index & Abstracts, ClinicalTrials.gov and MedRxiv. Hand searching of references from select articles was also performed.

SELECTION CRITERIA

Included studies described an intervention for those experiencing IPV during the perinatal period, including 12 months before pregnancy, while pregnant or in the 12 months post-partum. The search encompassed January 2000 to June 2022 and only peer-reviewed studies written in either English or French were included. Included interventions focused on the survivor exposed to IPV, rather than healthcare professionals administering the intervention. Interventions designed to reduce IPV revictimization or any adverse maternal, obstetrical, or neonatal health outcomes as well as social outcomes related to IPV victimization were included.

DATA COLLECTIONS AND ANALYSIS

We used standard methodological procedures expected by The Campbell Collaboration.

MAIN RESULTS

In total, 10,079 titles and abstracts were screened and 226 proceeded to full text screening. A total of 67 studies included perinatal IPV interventions and were included in the final sample. These studies included a total of 27,327 participants. Included studies originated from 19 countries, and the majority were randomized controlled trials ( = 43). Most studies were of moderate or low quality. Interventions included home visitation, educational modules, counseling, and cash transfer programs and occurred primarily in community obstetrician and gynecologist clinics, hospitals, or in participants' homes. Most interventions focused on reducing revictimization of IPV ( = 38), improving survivor knowledge or acceptance of violence, knowledge of community resources, and actions to reduce violence ( = 28), and improving maternal mental health outcomes ( = 26). Few studies evaluated the effect of perinatal IPV interventions on obstetrical, neonatal or child health outcomes.

AUTHORS' CONCLUSIONS: The majority of intervention studies for perinatal IPV focus on reducing revictimization and improving mental health outcomes, very few included obstetrical, neonatal, and other physical health outcomes. Future interventions should place a larger emphasis on targeting maternal and neonatal outcomes to have the largest possible impact on the lives and families of IPV survivors and their infants.

摘要

背景

亲密伴侣暴力(IPV)是一个普遍存在的全球健康问题。孕期前发生的亲密伴侣暴力在围产期往往会持续存在,导致暴力行为不断发生,并引发许多不良的孕产妇、产科和新生儿结局。

目的

本范围综述旨在广泛涵盖围产期亲密伴侣暴力的所有潜在干预措施,并描述其核心组成部分和测量结果。

检索方法

我们于2022年6月对描述围产期人群亲密伴侣暴力干预措施的实证研究进行了检索。检索在MEDLINE、EMBASE、PsycInfo、CINAHL、Cochrane对照试验中央注册库、科学引文索引、应用社会科学索引与摘要、ClinicalTrials.gov和MedRxiv中进行。我们还对选定文章的参考文献进行了手工检索。

入选标准

纳入的研究描述了针对围产期经历亲密伴侣暴力的人群的干预措施,包括怀孕前12个月、孕期或产后12个月。检索涵盖2000年1月至2022年6月,仅纳入以英文或法文撰写的同行评审研究。纳入的干预措施侧重于遭受亲密伴侣暴力的幸存者,而非实施干预措施的医疗保健专业人员。旨在减少亲密伴侣暴力再受害或任何不良的孕产妇、产科或新生儿健康结局以及与亲密伴侣暴力受害相关的社会结局的干预措施均被纳入。

数据收集与分析

我们采用了坎贝尔合作组织期望的标准方法程序。

主要结果

总共筛选了10079篇标题和摘要,226篇进入全文筛选。共有67项研究纳入了围产期亲密伴侣暴力干预措施并被纳入最终样本。这些研究共有27327名参与者。纳入的研究来自19个国家,大多数是随机对照试验(n = 43)。大多数研究质量中等或较低。干预措施包括家访、教育模块、咨询和现金转移项目,主要发生在社区妇产科诊所、医院或参与者家中。大多数干预措施侧重于减少亲密伴侣暴力的再受害(n = 38)、提高幸存者对暴力的认知或接受度、对社区资源的了解以及减少暴力的行动(n = 28),以及改善孕产妇心理健康结局(n = 26)。很少有研究评估围产期亲密伴侣暴力干预措施对产科、新生儿或儿童健康结局的影响。

作者结论

围产期亲密伴侣暴力的大多数干预研究侧重于减少再受害和改善心理健康结局,很少包括产科、新生儿和其他身体健康结局。未来的干预措施应更加强调针对孕产妇和新生儿结局,以对亲密伴侣暴力幸存者及其婴儿的生活和家庭产生最大可能的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3a5/11247475/ed568a41afee/CL2-20-e1423-g001.jpg

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