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首页> 外文期刊>BMC Family Practice >Developing a response to family violence in primary health care: the New Zealand experience
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Developing a response to family violence in primary health care: the New Zealand experience

机译：应对初级保健中的家庭暴力：新西兰的经验

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Background Despite primary health care being recognised as an ideal setting to effectively respond to those experiencing family violence, responses are not widely integrated as part of routine health care. A lack of evidence testing models and approaches for health sector integration, alongside challenges of transferability and sustainability, means the best approach in responding to family violence is still unknown. The Primary Health Care Family Violence Responsiveness Evaluation Tool was developed as a guide to implement a formal systems-led response to family violence within New Zealand primary health care settings. Given the difficulties integrating effective, sustainable responses to family violence, we share the experience of primary health care sites that embarked on developing a response to family violence, presenting the enablers, barriers and resources required to maintain, progress and sustain family violence response development. Methods In this qualitative descriptive study data were collected from two sources. Firstly semi-structured focus group interviews were conducted during 24-month follow-up evaluation visits of primary health care sites to capture the enablers, barriers and resources required to maintain, progress and sustain a response to family violence. Secondly the outcomes of a group activity to identify response development barriers and implementation strategies were recorded during a network meeting of primary health care professionals interested in family violence prevention and intervention; findings were triangulated across the two data sources. Results Four sites, representing three PHOs and four general practices participated in the focus group interviews; 35 delegates from across New Zealand attended the network meeting representing a wider perspective on family violence response development within primary health care. Enablers and barriers to developing a family violence response were identified across four themes: ‘Getting started’, ‘Building effective relationships’, ‘Sourcing funding’ and ‘Shaping a national approach to family violence’. Conclusions The strong commitment of key people dedicated to addressing family violence is essential for response sustainability and would be strengthened by prioritising family violence response as a national health target with dedicated resourcing. Further analysis of the health care system as a complex adaptive system may provide insight into effective approaches to response development and health system integration.
机译：背景技术尽管初级卫生保健被公认为是有效应对遭受家庭暴力的人的理想环境，但这些措施并未作为常规卫生保健的一部分得到广泛整合。缺乏用于卫生部门整合的证据测试模型和方法，以及可转让性和可持续性方面的挑战，这意味着应对家庭暴力的最佳方法仍然未知。开发了初级保健家庭暴力反应评估工具，作为在新西兰初级保健环境中实施由系统主导的针对家庭暴力的应对措施的指南。鉴于在整合有效，可持续的家庭暴力对策方面存在困难，我们分享了初级卫生保健站点的经验，这些站点着手制定对家庭暴力的对策，介绍了维持，进步和维持家庭暴力对策发展所需的推动力，障碍和资源。方法在定性描述性研究中，数据来自两个来源。首先，在对初级卫生保健场所进行24个月的跟踪评估访问期间，进行了半结构化的焦点小组访谈，以了解维持，发展和维持对家庭暴力的应对措施所需的推动力，障碍和资源。其次，在对家庭暴力预防和干预感兴趣的初级卫生保健专业人员网络会议期间，记录了确定应对发展障碍和实施策略的小组活动的结果;调查结果在两个数据源之间进行了三角测量。结果代表三个PHO和四个一般做法的四个地点参加了焦点小组访谈;来自新西兰各地的35名代表参加了网络会议，代表了对初级卫生保健中家庭暴力应对发展的更广阔视野。围绕四个主题确定了发展家庭暴力对策的推动力和障碍：“入门”，“建立有效的关系”，“寻求资金”和“塑造国家应对家庭暴力的方式”。结论致力于解决家庭暴力的关键人物的坚定承诺对于应对措施的可持续性至关重要，并将优先考虑将家庭暴力应对作为国家卫生目标，并通过专门的资源予以加强。对作为复杂的适应性系统的医疗保健系统的进一步分析可以提供对响应开发和医疗系统集成的有效方法的深入了解。

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