The experience of symptoms, minor to severe, prompts millions of patients to visit their healthcare providers each year. Symptoms not only create distress, but also disrupt social functioning. The management of symptoms and their resulting outcomes often become the responsibility of the patient and his or her family members. Healthcare providers have difficulty developing symptom management strategies that can be applied across acute and home-care settings because few models of symptom management have been tested empirically. To date, the majority of research on symptoms was directed toward studying a single symptom, such as pain or fatigue, or toward evaluating associated symptoms, such as depression and sleep disturbance. While this approach has advanced our understanding of some symptoms, we offer a generic symptom management model to provide direction for selecting clinical interventions, informing research, and bridging an array of symptoms associated with a variety of diseases and conditions. Finally, a broadly-based symptom management model allows the integration of science from other fields.

Objective  To evaluate the effectiveness of an empowerment intervention in reducing intimate partner violence (IPV) and improving health status. Design  Randomised controlled trial. Setting  Antenatal clinic in a public hospital in Hong Kong. Sample  One hundred and ten Chinese pregnant women with a history of abuse by their intimate partners. Methods  Women were randomised to the experimental or control group. Experimental group women received empowerment training specially designed for Chinese abused pregnant women while the control group women received standard care for abused women. Data were collected at study entry and six weeks postnatal. Main outcomes measures  IPV [on the Conflict Tactics Scale (CTS)], health‐related quality of life (SF‐36) and postnatal depression [Edinburgh Postnatal Depression Scale (EPDS)]. Results  Following the training, the experimental group had significantly higher physical functioning and had significantly improved role limitation due to physical problems and emotional problems. They also reported less psychological (but not sexual) abuse, minor (but not severe) physical violence and had significantly lower postnatal depression scores. However, they reported more bodily pain. Conclusion  An empowerment intervention specially designed for Chinese abused pregnant women was effective in reducing IPV and improving the health status of the women.

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Context Intimate partner violence against women can have negative mental health consequences for survivors. The effect of interventions designed to improve the survivors' depressive symptoms is unclear.Objective To determine whether an advocacy intervention would improve the depressive symptoms of Chinese women survivors of intimate partner violence' Design, Setting, and Participants Assessor-blind, randomized controlled trial of 200 Chinese women aged 18 years or older with ahistory of intimate partner violence was conducted from February 2007 to June 2009 in a community in Hong Kong, China. Participants were randomly assigned to an intervention or control group.Intervention The intervention group (n:100) received a l2-week advocacy intervention comprising empowerment and telephone social support. The control group (n:100) received usual community services including child care, health care and promotion, and recreational programs.Main Outcome Measures The primary outcome was change in depressive symptoms (Chinese Version of Beck Depression Inventory II) between baseline and 9 months. The minimal clinically important difference was 5 units. Secondary outcomes were changes in intimate partner violence (Chinese Revised Conflict Tactics Scales), health-related qualrty of life (Short Form Health 12 Survey) and perceived social support (Interpersonal Support Evaluation List) between baseline and 9 months. The usefulness of the intervention/usual community services was evaluated at 9 months. Results At 3 months, the mean change of depressive symptoms was 1I.6 (95% confidence interval [CI], 9.5-13.7) in the control group and 14'9 (95yo Cl, in the intervention group. The respective mean changes at 9 months were 19.6 (95o/o CI, 16.6-22.7) and,23.2 (95o CI,20.4-26.0). The intervention effects at 3 and 9 months were not significantly different (P:.86). The intervention significantly reduced depressive symptoms over the control by 2.66 (95Yo,0.26-5.06; P:.03) which was less thanthe minimal clinically important difference. Among the secondary outcomes, statistically significant improvement was found in psychological aggression (-1.87;95% CI: -3.34, -0.40; 3 months: mean change from baseline : 1.5 [95yo CI, -1.0 to 3.9] in the control group and 0.3 l95yo CI, -0.7 to 1.41 in the intervention group; 9 months: mean change from baseline : -6.4195% CI, -7.8 to -5.0] in the control group and -8.9 l95yo CI, -10.6 to -7 .21inthe intervention group) and perceived social support (2.18; 95% CI: 0.48 to 3.89; 3 months: mean change from baseline: 6.4 l95o/o CI, 4.9-7 .8] in the control group and 9 .2 [95yo CI, 7 .7 -10.8] in the intervention group; 9 months: mean change from baseline: 12.4l95yo CI,10.5-14.31 in the control group and I4.4195% CI, l2.l-16.Il in the intervention group) but not in physical assault, sexual coercion, and health-related quality of life. By the end of the study, more women in the intervention group found the intervention to be useful-extremely useful in improving their intimate relationships vs those in the con...

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