Violence Against Health Care Workers: Understanding Context Through Citizen Science and Measuring a De-escalation Training Intervention Effectiveness in Eastern Democratic Republic of Congo and Iraq
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 798
- 试验地点
- 2
- 主要终点
- Incidence and severity of self-reported non-physical aggression
研究概览
简要总结
The general objective of the project is to assess whether a violence de-escalating training for health professionals and of a publicly displayed Code of Conduct (a set of rules developed through a citizen science and co-design approach) for both health professionals and clients at the level of the health facility, can reduce the incidence and severity of episodes of violence, and to identify the most cost-effective way to implement these interventions in rural Democratic Republic of Congo (DRC) and in the mega city of Baghdad, Iraq.
详细描述
The study will adopt a stepped-wedge cluster-randomized intervention trial (SW-CRT) design to assess the two intervention components, a violence de-escalating training and the implementation of the code of conduct co-developed during the formative qualitative phase. The study will adopt a closed cohort with repeated measurements on the same participants (nurses in DRC and junior doctors in Baghdad) and will involve the unidirectional transition of each enrolled cluster (health facilities in DRC and secondary hospitals in Baghdad) from the control (no intervention) to the intervention sequence in a randomized sequential manner according to a predefined roll out process.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- Double (Investigator, Outcomes Assessor)
盲法说明
Only the statistician and the PI will be aware of the allocation order sequence, while the country co-investigators will be blinded to the allocation sequence and only the next health facility/secondary hospital randomized for roll out will be revealed at each crossover intervention implementation time point. The outcome assessors will also be blinded.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •HCWs from selected participating health facilities in DRC, junior doctors during their first year resident and permanent health care staff from participating secondary hospitals in Iraq
- •HCWs and junior medical doctors and permanent health care staff must have been employed/ or worked as HCW/ medical doctors or as permanent health care staff for at least 6 months
- •All above participants must have completed the written informed consent
排除标准
- •Age <18 years; cognitive impairment
研究组 & 干预措施
Arm 1 De-escalating violence training
The de-escalating violence training intervention will be introduced after a pre-interventional period of 3 months. A refreshment training will be introduced at month 11.
干预措施: Training in de-escalating violence (Behavioral)
Arm 2 De-escalating violence training
The de-escalating violence training intervention will be introduced before the second observation period at month 11. A refreshment training will be introduced at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 3 De-escalating violence training
The de-escalating violence training intervention will be introduced before the third observation period at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 4 De-escalating violence training + Code of conduct
The de-escalating violence training intervention will be introduced after a pre-interventional period of 3 months. The code of conduct via a warning board will be introduced at month 11. A refreshment training will be introduced at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 4 De-escalating violence training + Code of conduct
The de-escalating violence training intervention will be introduced after a pre-interventional period of 3 months. The code of conduct via a warning board will be introduced at month 11. A refreshment training will be introduced at month 18.
干预措施: Code of conduct delivered via a warning board (Behavioral)
Arm 5 De-escalating violence training + Code of conduct
The de-escalating violence training intervention and the code of conduct via a warning board will be simultaneously introduced at month 11. A refreshment training will be introduced at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 5 De-escalating violence training + Code of conduct
The de-escalating violence training intervention and the code of conduct via a warning board will be simultaneously introduced at month 11. A refreshment training will be introduced at month 18.
干预措施: Code of conduct delivered via a warning board (Behavioral)
Arm 6 Code of conduct + De-escalating violence training
The code of conduct via a warning board will be introduced at month 11. The de-escalating violence training intervention will be introduced at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 6 Code of conduct + De-escalating violence training
The code of conduct via a warning board will be introduced at month 11. The de-escalating violence training intervention will be introduced at month 18.
干预措施: Code of conduct delivered via a warning board (Behavioral)
Arm 7 De-escalating violence training + Code of conduct
The de-escalating violence training intervention is introduced after a pre-interventional period of 3 months. The code of conduct via a warning board and a refreshment training will be simultaneously introduced at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 7 De-escalating violence training + Code of conduct
The de-escalating violence training intervention is introduced after a pre-interventional period of 3 months. The code of conduct via a warning board and a refreshment training will be simultaneously introduced at month 18.
干预措施: Code of conduct delivered via a warning board (Behavioral)
Arm 8 De-escalating violence training + Code of conduct
The de-escalating violence training intervention will be introduced before the second observation period at month 11. The code of conduct via a warning board and a refreshment training will be simultaneously introduced at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 8 De-escalating violence training + Code of conduct
The de-escalating violence training intervention will be introduced before the second observation period at month 11. The code of conduct via a warning board and a refreshment training will be simultaneously introduced at month 18.
干预措施: Code of conduct delivered via a warning board (Behavioral)
Arm 9 De-escalating violence training + Code of conduct
The code of conduct via a warning board and the violence de-escalating training will be simultaneously introduced at month 18.
干预措施: Training in de-escalating violence (Behavioral)
Arm 9 De-escalating violence training + Code of conduct
The code of conduct via a warning board and the violence de-escalating training will be simultaneously introduced at month 18.
干预措施: Code of conduct delivered via a warning board (Behavioral)
Arm 10 Code of conduct
The code of conduct via a warning board will be introduced at month 11.
干预措施: Code of conduct delivered via a warning board (Behavioral)
Arm 11 Code of conduct
The code of conduct via a warning board will be introduced at month 18.
干预措施: Code of conduct delivered via a warning board (Behavioral)
结局指标
主要结局
Incidence and severity of self-reported non-physical aggression
时间窗: 6 months
Number of self-reported non-physical aggression (verbal abuse, threats, ironic language, provocative or aggressive body language etc.) during the fulfillment of a professional activity in the last 6 months
Incidence and severity of self-reported physical aggression
时间窗: 6 months
Number of self-reported physical aggression during the fulfillment of a professional activity in the last 6 months
次要结局
- Level of post-traumatic stress disorders (PTSD) among HCWs(0, 6, 12, 18 months)
- Level of confidence in coping with patient aggression(0, 6, 12, 18 months)
- Level of burnout among HCWs(0, 6, 12, 18 months)
- Psychological empathy among HCWs(0, 6, 12, 18 months)
- Absenteeism(0, 6, 12, 18 months)
- Intent to leave among HCWs(0, 6, 12, 18 months)
- Economic cost of the intervention(18 months)
- Productivity loss (presenteeism)(18 months)
- Health care workers health-related quality of life(0, 6, 12, 18 months)