COVID-19 adaptations to a training and support programme to improve primary care response to domestic abuse: a mixed methods rapid study

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Lucy Downes, Estela Capelas Barbosa
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引用次数: 0

Abstract

Increased incidence and/or reporting of domestic abuse (DA) accompanied the COVID-19 pandemic. National lockdowns and enforced social isolation necessitated new ways of supporting victims of DA remotely. Identification and Referral to Improve Safety (IRIS) is a programme to improve the response to domestic abuse in general practice, providing training for general practice teams and support for patients affected by DA, which has previously been proven effective and cost-effective [1–3]. The COVID-19 pandemic required the adaptation of the programme to online training and remote support. This study is mixed methods rapid research, which aimed to gather evidence around the relevance, desirability and acceptability of IRIS operating remotely. Quantitative IRIS referral data were triangulated with data from four surveys and 15 interviews. Participants were local IRIS teams, IRIS-trained clinicians, and victim-survivors supported by IRIS services. The study was designed using the Lean Impact approach, allowing quick evaluation of innovation and the impact of social interventions. We carried out a framework analysis of the interviews, which is a qualitative methodology widely used in policy and applied research that enables research teams to move from descriptive accounts to a conceptual explanation of findings [4, 5]. We found that the adaptation to online training and support of IRIS was acceptable and desirable. Most clinicians felt confident addressing DA over the phone and online, although most were more confident face-to-face. While referrals to IRIS services initially declined in March 2020, numbers of referrals increased to pre-pandemic levels by July 2020. Patients felt well supported remotely, although patients who had previously experienced face-to-face support preferred it. Technology was the most frequently mentioned barrier to the change from face-to-face training and support to online training and remote support. This study contributes to practice by asserting the desirability and acceptability of training clinicians to be able to identify, ask about DA and refer to the IRIS programme during telephone/online consultations. This is of relevance to health and public health commissioners when making commissioning decisions to improve the general practice response to domestic abuse.
COVID-19 对培训和支持计划进行调整,以改善基层医疗机构对家庭虐待的应对:一项混合方法快速研究
在 COVID-19 大流行的同时,家庭虐待(DA)的发生率和/或报告率也有所上升。由于全国性的封锁和强制的社会隔离,有必要采取新的方式为家庭暴力受害者提供远程支持。识别和转诊以提高安全性(IRIS)是一项旨在改善全科医生应对家庭虐待的计划,为全科医生团队提供培训,并为受家庭虐待影响的患者提供支持,该计划已被证明有效且具有成本效益[1-3]。COVID-19 大流行要求将该计划调整为在线培训和远程支持。本研究是一项混合方法的快速研究,旨在围绕 IRIS 远程操作的相关性、可取性和可接受性收集证据。IRIS 转介的定量数据与来自四项调查和 15 次访谈的数据进行了三角测量。参与者包括当地的 IRIS 团队、接受过 IRIS 培训的临床医生以及获得 IRIS 服务支持的受害者-幸存者。研究采用精益影响方法进行设计,以便快速评估创新和社会干预措施的影响。我们对访谈进行了框架分析,这是一种广泛应用于政策和应用研究的定性方法,可使研究团队从描述性叙述转向对研究结果的概念性解释[4, 5]。我们发现,对 IRIS 在线培训和支持的调整是可以接受的,也是可取的。大多数临床医生都有信心通过电话和在线方式解决伤残评估问题,尽管大多数人面对面时更有信心。2020 年 3 月,转诊到 IRIS 服务的人数开始减少,但到 2020 年 7 月,转诊人数已增加到疫情流行前的水平。尽管以前有过面对面支持经历的患者更喜欢远程支持,但患者认为远程支持很好。从面对面培训和支持到在线培训和远程支持,技术是最常被提及的障碍。这项研究表明,对临床医生进行培训,使其能够在电话/在线咨询中识别、询问DA并转介至IRIS计划,是可取和可接受的,从而为实践做出了贡献。这与卫生和公共卫生专员在做出委托决策以改善全科医生对家庭虐待的应对措施时息息相关。
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来源期刊
BMC Family Practice
BMC Family Practice 医学-医学:内科
CiteScore
3.20
自引率
0.00%
发文量
0
审稿时长
4-8 weeks
期刊介绍: BMC Family Practice is an open access, peer-reviewed journal that considers articles on all aspects of primary health care research. The journal has a special focus on clinical decision making and management, continuing professional education, service utilization, needs and demand, and the organization and delivery of primary care and care in the community.
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