McFarlane J, Wiist W
College of Nursing, Texas Woman's University, Houston, TX 77030, USA.
J Community Health Nurs. 1997;14(4):237-49. doi: 10.1207/s15327655jchn1404_3.
Abuse to pregnant women is common and can result in complications to maternal and child health. Although screening and detection of abuse in primary health care settings is becoming more commonplace, intervention models that include community outreach have not been developed or tested. An advocacy model was developed and tested for pregnant abused women by melding research on advocacy programs for abused women exiting shelters with the principles of home visitation used to improve outcomes to pregnant women. Advocacy was offered by "mentor mothers," who were residents of the project's service area. The advocacy consisted of weekly social support, education, and assisted referrals to pregnant women identified as abused as part of routine screening offered at the first prenatal visit to a public health clinic. Effectiveness of the advocacy intervention was measured as contact success rate, number and type of advocacy contacts, and number and type of referrals made to the first 100 women to complete the advocacy program. The mentor mother advocates were successful in contacting the abused woman 33% of the time, regardless of whether a telephone call, home visitation, or in-person meeting was attempted. The average number of advocacy contacts was 9.2 (SD = 7.6) with the majority (74%) being via the telephone. The average number of referrals per woman was 8.6 (SD = 7.6) with the largest percentage (38%) being for medical services. Outreach advocacy as an intervention model for pregnant abused women is recommended.
对孕妇的虐待很常见，可能会导致母婴健康出现并发症。尽管在初级卫生保健机构中筛查和发现虐待行为变得越来越普遍，但尚未开发或测试包括社区外展在内的干预模式。通过将针对离开庇护所的受虐妇女的宣传项目研究与用于改善孕妇结局的家访原则相结合，开发并测试了一种针对受虐孕妇的宣传模式。宣传由“指导母亲”提供，她们是该项目服务区域的居民。宣传内容包括每周的社会支持、教育，并协助为在公共卫生诊所首次产前检查时被确定为受虐的孕妇进行转介。宣传干预的有效性通过联系成功率、宣传联系的数量和类型以及为完成宣传项目的前100名妇女进行转介的数量和类型来衡量。指导母亲宣传者成功联系到受虐妇女的时间占33%，无论尝试的是电话联系、家访还是面对面会议。宣传联系的平均次数为9.2次（标准差 = 7.6），其中大部分（74%）是通过电话进行的。每名妇女的平均转介次数为8.6次（标准差 = 7.6），其中最大比例（38%）是转介到医疗服务机构。建议将外展宣传作为受虐孕妇的一种干预模式。
