Comparable outcomes in quality of life with/(out) partner violence screening intervention .
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(5):34 JAMA. 2012 Aug 15;308(7):681-9Exclusive Author Interview
Dr. Klevens speaks on screening for intimate partner violence.
2708 English- or Spanish-speaking women were randomised to undergo an intervention involving a computerized partner violence screening with a partner violence resource list, an intervention with just a partner violence resource list, or a control group with neither. The primary outcome was health-related quality of life. The results indicated that no significant differences were seen between the three groups on the outcome of quality of life at the one-year follow-up.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sim = 1
Incerto = 0,5
Não relevante = 0
Não = 0
A Avaliação dos Critérios de Relato avalia a transparência com que os autores relatam as caraterísticas metodológicas e do ensaio na publicação. A avaliação está dividida em cinco categorias que são apresentadas de seguida.
4/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
O Índice de Fragilidade é uma ferramenta que auxilia na interpretação de achados significativos, fornecendo uma medida de força para um resultado. O Índice de Fragilidade representa o número de eventos consecutivos que precisam de ser adicionados a um resultado dicotómico para que o resultado deixe de ser significativo. Um número pequeno representa um resultado mais fraco e um número grande representa um resultado mais forte.
Porque é que este estudo era necessário agora?
Partner violence is considered a health and public health problem. Screening for partner violence has been recommended by a number of health organizations. However, there is a lack of evidence that supports that this intervention results in improvement in health-related outcomes. This study examines the effect of screening for partner violence on the quality of life of women.
Qual era a principal questão de investigação?
What are the outcomes in quality of life for women participating in an intervention involving a computerized screening for partner violence with a partner violence resource list, an intervention with only a violence resource list, or no intervention at all over a one-year follow-up period?
- No significant differences were observed in the QOL physical health component between Group 1 (Screen and resource list) (n=801; mean score, 46.8; 95% CI, 46.1-47.4), Group 2 (Resource list only) (n=772; mean score, 46.4; 95% CI, 45.8-47.1), and Group 3 (Control) (n=791; mean score, 47.2; 95% CI, 46.5-47.8) at the 1-year follow-up.
- No significant differences were observed between the three groups on the mental health component (Group 1: Mean score, 48.3; 95% CI, 47.5-49.1; Group 2: Mean score, 48.0; 95% CI, 47.2-48.9; Group 3: Mean score, 47.8; 95% CI, 47.0-48.6).
- No significant differences were seen between the three groups on the the outcomes of: number of days unable to work (p=0.96) or complete housework (p=0.66), hospitalizations (p=0.40), visits from ambulatory care (p=0.12) or the emergency department (p=0.40), recurrence of partner violence (Screened group compared to control: p=0.16; Resource list group compared to control: p=0.12), or patients who contacted a partner violence agency (Screened group compared to control: p=0.60; Resource list group compared to control: p=0.21).
De que é que me devo lembrar mais?
No significant improvement of health-related quality of life was observed when women seeking care in outpatient clinical settings were provided a partner violence resource list with or without a screening intervention compared to controls.
Como é que isto afectará o tratamento dos meus doentes?
Computerized partner violence screening and the provision of a partner violence resource list to those who screened positive did not provide any significant improvements in health-related quality of life. It is unclear if the population studied (all outpatients) is representative of an orthopaedic practice (i.e. fracture clinic), and thus difficult to generalize results. Other forms of intervention need to be developed to provide better care for those suffering from partner violence.
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