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基于医院的暴力干预项目参与与暴力伤害幸存者创伤相关心理症状之间的关联。

Association Between Healing Hurt People Hospital-Based Violence Intervention Program Participation and Trauma-Related Psychological Symptoms for Violent Injury Survivors.

作者信息

Corbin Theodore J, Tabb Loni P, Waite Daria B, Xu Yang, Townsend Shanna-Kay, Zinny Arturo, Harris Erica, Gardner James, Gentile Nina, Isgor Zeynep, Rich John A

机构信息

Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.

Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.

出版信息

J Am Coll Emerg Physicians Open. 2025 Jul 24;6(5):100199. doi: 10.1016/j.acepjo.2025.100199. eCollection 2025 Oct.

Abstract

OBJECTIVES

Examine associations between engagement with the hospital-based violence intervention program, Healing Hurt People (HHP), and trauma-related psychological symptoms among violently injured people ages 18 to 30 years.

METHODS

Participants selected from 3 hospitals' emergency departments (EDs) completed clinical scales for posttraumatic stress disorder (PTSD) with the PTSD Checklist for DSM-5 (PCL-5), depression with the Patient Health Questionnaire -8 (PHQ-8), sleep with the Patient-Reported Outcomes Measurement Information System (PROMIS), and perceived stress with the perceived stress scale at baseline (≤90 days after presenting to ED) and follow-up (intended follow-up 6 months after baseline). Controls were selected from the EDs of 2 hospitals before the launch of HHP between 2015 and 2016. Most intervention group participants were selected from the ED of the hospital where HHP was operational between 2014 and 2020. We performed linear and logistic regression analyses for associations between program participation and posttraumatic stress disorder, depression, sleep, and perceived stress, adjusting for baseline scores, age, sex (assigned at birth), race/ethnicity, injury type, and days between baseline and follow-up.

RESULTS

The analytical sample contained 47 control and 43 intervention participants. In linear regressions, HHP was not associated with changes in any trauma-related psychological symptom scores. In logistic regressions, HHP was associated with a 9 and 21 percentage-point increase in the probability of any improvement in depression and sleep, respectively.

CONCLUSION

This study's findings constitute descriptive (ie, not causal) evidence, which suggests that HHP may be associated with improvements in trauma-related psychological symptoms. When randomized control trials are not feasible, future research using quasi-experimental studies that can better address unobserved heterogeneity is needed to evaluate hospital-based violence intervention programs.

摘要

目的

研究参与基于医院的暴力干预项目“治愈受伤的人”(Healing Hurt People,HHP)与18至30岁暴力受伤者创伤相关心理症状之间的关联。

方法

从3家医院急诊科选取的参与者使用《精神疾病诊断与统计手册》第5版创伤后应激障碍检查表(PCL-5)完成创伤后应激障碍(PTSD)临床量表,使用患者健康问卷-8(PHQ-8)完成抑郁量表,使用患者报告结局测量信息系统(PROMIS)完成睡眠量表,并在基线期(就诊急诊科后≤90天)和随访期(基线期后预期随访6个月)使用感知压力量表完成感知压力量表。对照组于2015年至2016年HHP项目启动前从2家医院的急诊科选取。大多数干预组参与者于2014年至2020年从实施HHP项目的医院急诊科选取。我们进行线性和逻辑回归分析,以研究项目参与与创伤后应激障碍、抑郁、睡眠和感知压力之间的关联,并对基线分数、年龄、性别(出生时指定)、种族/族裔、损伤类型以及基线期和随访期之间的天数进行调整。

结果

分析样本包括47名对照参与者和43名干预参与者。在线性回归中,HHP与任何创伤相关心理症状评分的变化均无关联。在逻辑回归中,HHP分别与抑郁和睡眠改善概率增加9个和21个百分点相关。

结论

本研究结果构成描述性(即非因果性)证据,表明HHP可能与创伤相关心理症状的改善有关。当随机对照试验不可行时,未来需要使用能够更好地解决未观察到的异质性的准实验研究来评估基于医院的暴力干预项目。

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