PubMed Health⌕ Search

Biomedical subjects

C Nadine Wathen

Publications and source records attributed to C Nadine Wathen.

15 recordsLinked to original sources
PubMed2006

Approaches to screening for intimate partner violence in health care settings: a randomized trial.

CONTEXT: Screening for intimate partner violence (IPV) in health care settings has been recommended by some professional organizations, although there is limited information regarding the accuracy, acceptability, and completeness of different screening methods and instruments. OBJECTIVE: To determine the optimal method for IPV screening in health care settings. DESIGN AND SETTING: Cluster randomized trial conducted from May 2004 to January 2005 at 2 each of emergency departments, family practices, and women's health clinics in Ontario, Canada. PARTICIPANTS: English-speaking women aged 18 to 64 years who were well enough to participate and could be seen individually were eligible. Of 2602 eligible women, 141 (5%) refused participation. INTERVENTION: Participants were randomized by clinic day or shift to 1 of 3 screening approaches: a face-to-face interview with a health care provider (physician or nurse), written self-completed questionnaire, and computer-based self-completed questionnaire. Two screening instruments-the Partner Violence Screen (PVS) and the Woman Abuse Screening Tool (WAST)-were administered and compared with the Composite Abuse Scale (CAS) as the criterion standard. MAIN OUTCOME MEASURES: The approaches were evaluated on prevalence, extent of missing data, and participant preference. Agreement between the screening instruments and the CAS was examined. RESULTS: The 12-month prevalence of IPV ranged from 4.1% to 17.7%, depending on screening method, instrument, and health care setting. Although no statistically significant main effects on prevalence were found for method or screening instrument, a significant interaction between method and instrument was found: prevalence was lower on the written WAST vs other combinations. The face-to-face approach was least preferred by participants. The WAST and the written format yielded significantly less missing data than the PVS and other methods. The PVS and WAST had similar sensitivities (49.2% and 47.0%, respectively) and specificities (93.7% and 95.6%, respectively). CONCLUSIONS: In screening for IPV, women preferred self-completed approaches over face-to-face questioning; computer-based screening did not increase prevalence; and written screens had fewest missing data. These are important considerations for both clinical and research efforts in IPV screening. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00336297.

Adult↗
PubMed2006

Alternatives to hormone replacement therapy: a multi-method study of women's experiences.

OBJECTIVE: To explore women's decision-making regarding use of complementary and alternative medicines (CAM) during menopause. METHODS: Qualitative interviews were conducted with 20 women who were currently or had previously used hormone replacement therapy (HRT), including questions about their experiences with alternatives to HRT. This was followed by a non-random questionnaire survey of 285 demographically representative Canadian women aged 45-65 who were current or former HRT users. RESULTS: Fifty-seven percent (57%, n = 162) of women reported either having used or considered a CAM approach for menopause. Women who had tried or considered CAM were significantly younger (mean age = 54.9 years versus 56.8 years; t(280) = 3.4, p < .05) and reported experiencing worse menopause-specific symptoms than those who had not, and these women also reported a worse experience of menopause overall. CONCLUSION: : A majority of menopausal women in the current study considered or tried CAM alternatives to HRT.

Aged↗
PubMed2006

Research-practice gaps in child mental health.

OBJECTIVES: To present a framework for classifying research-practice gaps to increase clarity in the discourse on evidence-informed practice and policy as it applies to child mental health. METHOD: The development of the framework was informed by the research literature about the effectiveness of clinic- and community-based interventions for the prevention and treatment of child mental health problems, patterns of uptake of these interventions, and the research literature about evidence-informed practice and policy. RESULTS: Four types of research-practice gaps are proposed: (1) the failure to implement interventions found to be effective, and the implementation of interventions (2) that have been demonstrated to cause harm, (3) that have evidence of no effect, and (4) where the effectiveness is unknown because of the lack of rigorous evaluation. Examples from child mental health are provided for each type. CONCLUSIONS: This framework could guide an agenda aimed at reducing research-practice gaps in child mental health. A range of strategies may be required to address the different types of gaps.

Child↗
PubMed2005

Treatment of child neglect: a systematic review.

OBJECTIVE: Child neglect is the most common type of child maltreatment. Our objective was to systematically evaluate the available evidence regarding the effectiveness of child neglect treatment programs, including those focused on victims of childhood neglect and (or) their caregivers. METHOD: We comprehensively searched the Medline, Psycinfo, and Eric databases from January 1980 to May 2003. Two authors independently reviewed 54 studies that met inclusion criteria. Fourteen articles met our design criterion and were assessed for their methodological quality according to guidelines developed by the US Preventive Services Task Force. RESULTS: Of the 14 studies included in the review, 2 were rated as good, and 3 were rated as fair. We found evidence that 2 specific types of play therapy and a therapeutic day treatment program had beneficial effects for children. Further, parents and children in families where neglect had occurred showed improvement with multisystemic therapy. CONCLUSIONS: Rigorous studies of treatments for neglected children and their families are lacking. Well-designed and well-conducted evaluations are urgently required to identify effective treatments, which should then be made available to children and their caregivers.

Child↗
PubMed2004

Should health professionals screen all women for domestic violence?

BACKGROUND TO THE DEBATE: The US and Canadian task forces on preventive health recently declared that there is not enough evidence to recommend for or against routine universal screening of women for domestic violence. Yet some experts argue that routine enquiry is justified.

Decision Making↗
PubMed2003

Interventions for violence against women: scientific review.

CONTEXT: Intimate partner violence is prevalent and is associated with significant impairment, yet it remains unclear which interventions, if any, reduce rates of abuse and reabuse. OBJECTIVE: To systematically review, from the perspective of primary health care, the available evidence on interventions aimed at preventing abuse or reabuse of women. DATA SOURCES: MEDLINE, PsycINFO, CINAHL, HealthStar, and Sociological Abstracts were searched from the database start dates to March 2001 using database-specific key words such as domestic violence, spouse abuse, partner abuse, shelters, and battered women. References of key articles were hand searched. The search was updated in December 2002. STUDY SELECTION: Both authors reviewed all titles and abstracts using established inclusion/exclusion criteria. Twenty-two articles met the inclusion criteria for critical appraisal. DATA EXTRACTION: Following the evidence-based methods of the Canadian Task Force on Preventive Health Care, both authors independently reviewed the 22 included studies using an established hierarchy of study designs and criteria for rating internal validity. Quality ratings of individual studies--good, fair, or poor--were determined based on a set of operational parameters specific to each design category developed with the US Preventive Services Task Force. DATA SYNTHESIS: Screening instruments exist that can identify women who are experiencing intimate partner violence. No study has examined, in a comparative design, the effectiveness of screening when the end point is improved outcomes for women (as opposed to identification of abuse). No high-quality evidence exists to evaluate the effectiveness of shelter stays to reduce violence. Among women who have spent at least 1 night in a shelter, there is fair evidence that those who received a specific program of advocacy and counseling services reported a decreased rate of reabuse and an improved quality of life. The benefits of several other intervention strategies in treating both women and men are unclear, primarily because of a lack of suitably designed research measuring appropriate outcomes. In most cases, the potential harms of interventions are not assessed within the studies reviewed. CONCLUSIONS: Much has been learned in recent years about the epidemiology of violence against women, yet information about evidence-based approaches in the primary care setting for preventing intimate partner violence is seriously lacking. The evaluation of interventions to improve the health and well-being of abused women remains a key research priority.

Behavior Therapy↗
PubMedDate not supplied

Health information seeking in context: how women make decisions regarding hormone replacement therapy.

This multimethod study explored women's information seeking behaviour and decision making regarding menopause, hormone replacement therapy (HRT), and use of complementary and alternative medicines (CAM) during menopause. This research was underway during the mass media release of the Women's Health Initiative (WHI) estrogen-progestin trial results, allowing an examination of the impact of this news on women's decisions. There were two studies: first, 20 women who currently were or previously had used HRT were interviewed about their experiences with menopause and HRT-related information seeking and decision making. Following this, 285 demographically representative Canadian women aged 45-65 who were current or former HRT users completed a questionnaire. Results indicate that women's information behaviour differed according to which decision they were making (starting versus stopping HRT, considering CAM), as did the sources they consulted. In general, there has been a paucity of good information to help women who are deciding to stop HRT. The types and sources of CAM information often are found to be less than credible and helpful. When information is lacking, women rely on informal sources, and on their own judgement, to make decisions. The results are discussed in the context of information behaviour and help-seeking theory.

Aged↗