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Gender-based or sexual violence, or violence against women (VAW), is a global public health problem affecting around 30% of women over the age of 15, with significant consequences for physical and mental health, including depression and post-traumatic stress disorder (PTSD).
In 2019, the French National Authority for Health (HAS) published recommendations in two parts, one for identifying women who are victims of domestic violence, and the other for dealing with a woman who has been exposed to such violence. But violence against women is not limited to the marital sphere. VAW can simply be detected in a consultation using a translated version of the Abuse Assessment Screen (AAS) questionnaire.
Women who are victims of VAW have specific needs linked to the often repeated nature of the violence they experience, and the complex trauma that can ensue. They also tend to combine other risk factors for poor mental health, such as economic insecurity and social isolation. In France, dealing with the specific medical, psychosocial and legal needs of victims-survivors of VAW has come up against a number of obstacles, including a lack of dedicated care facilities, a lack of trained professionals and a lack of coordination between the various parties. Health professionals rarely receive the training they need to deal with VAW-related issues with confidence and professionalism, and often lack the resources to refer female victims to appropriate care.
"La Maison des Femmes" (MdF) was set up in 2016 in Saint-Denis, located in a department where a quarter of the women who consult a family planning centre (FPC) has suffered from VAW. It is a hospital service specifically dedicated to the individualised, multidisciplinary care of victims-survivors of VAW, offering health, social and legal support within the same facility. The MdF comprises 4 units: a FPC, a violence management unit (involving doctors, midwives, psychologists, social workers, lawyers, police officers and support groups), a female genital mutilation management unit (surgeons and sexologists) and a 24/7 reception unit for victims of sexual violence.
Several MdF-inspired care structures have been set up in France. The service provided by these facilities needs to be evaluated, particularly in terms of their ability to improve the physical and mental health, including post-traumatic stress, of women who have been victims of VAW.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| experimental group | Women cared for in a women's centre |
| |
| comparator group | Women in a health centre or family planning centre. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| completion of scales and questionnaires | Other | Patient questionnaires Abuse assessment Screen, Evaluation of the PCL-5 score, Measurement of insomnia severity indexes (ISI), quality of life scores (WHOQOL-BREF), anxiety and depression using the HAD scale (Hospital Anxiety and Depression), self-esteem score using the Rosenberg scale, feeling of security and well-being using five-point Likert scales. Questionnaire on daily and occasional smoking, alcohol consumption using the Alcohol Use Disorders Identification Test-Concise (AUDIT-C), cannabis dependence using the Cannabis Abuse Screening Test (CAST) and use of other psychoactive substances. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in mean PCL-5 score | measured using the validated French version of the Post-traumatic Stress Disorder Checklist for DSM-V (score from 0 to 80). | Through study completion, an average of 6 months |
| Change in the proportion of women with a PCL-5 score < 33 (validated threshold for absence of overt PTSD) | measured using the validated French version of the Post-traumatic Stress Disorder Checklist for DSM-V (score from 0 to 80). | Through study completion, an average of 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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Eligible patients will be identified by a doctor at one of the participating centres, on the basis of their response to the AAS questionnaire during the initial consultation.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marc DOMMERGUES | Contact | 01 42 17 77 01 | +33 | marc.dommergues@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chu Dijon Bourgogne | Recruiting | Dijon | 21000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39566954 | Derived | El-Khoury F, Ben Ghezala I, Hatem G, Jaffal Z, Soares A, Yacini L, Duchesne S, Dommergues M, Bretelle F, Eudeline S, Hoffmann P, Masse-Navette C, Layachi F, Maurice O, de Foucher de Careil T, Bardou M. IROND-L: study protocol for a French prospective, quasi-experimental, multicentre trial to examine the impact of a coordinated multidisciplinary approach for women victims of violence. BMJ Open. 2024 Nov 19;14(11):e086143. doi: 10.1136/bmjopen-2024-086143. |
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|
| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
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