Frayne S M, Skinner K M, Sullivan L M, Tripp T J, Hankin C S, Kressin N R, Miller D R
Boston VA Medical Center, Massachusetts, USA.
J Womens Health Gend Based Med. 1999 Jul-Aug;8(6):835-45. doi: 10.1089/152460999319156.
To profile differences in current physical symptoms and medical conditions among women users of Veterans Administration (VA) health services with and without a self-reported history of sexual assault sustained during military service, we conducted a cross-sectional analysis of a nationally representative, random sample of women veterans using VA outpatient services (n = 3632). A self-administered, mailed survey asked whether women had sustained sexual assault while in the military and requested information about a spectrum of physical symptoms and medical conditions. A history of sexual assault while in the military was reported by 23% of women VA users and was associated with current physical symptoms and medical conditions in every domain assessed. For example, women who reported sexual assault were more likely to indicate that they had a "heart attack" within the past year, even after adjusting for age, hypertension, diabetes, and smoking history (OR 2.3, 95% CI 1.3-4.0). Among women reporting a history of sexual assault while in the military, 26% endorsed > or = 12 of 24 symptoms/conditions, compared with 11% of women with no reported sexual assault while in the military (p < 0.001). Clinicians need to be attuned to the high frequency of sexual assault occurring while in the military reported by women VA users and its associated array of current physical symptoms and medical conditions. Clinicians should consider screening both younger and older patients for a sexual violence history, especially patients with multiple physical symptoms.
为了剖析在退伍军人事务部（VA）接受医疗服务的女性使用者中，有或没有自述在服役期间遭受性侵犯经历的人群在当前身体症状和医疗状况上的差异，我们对使用VA门诊服务的具有全国代表性的女性退伍军人随机样本（n = 3632）进行了横断面分析。一份自行填写的邮寄调查问卷询问了女性在服役期间是否遭受过性侵犯，并要求提供一系列身体症状和医疗状况的信息。23%的女性VA使用者报告在服役期间有过性侵犯经历，且在每个评估领域都与当前的身体症状和医疗状况相关。例如，报告有性侵犯经历的女性更有可能表示在过去一年中曾“心脏病发作”，即使在调整了年龄、高血压、糖尿病和吸烟史之后（比值比2.3，95%置信区间1.3 - 4.0）。在报告有服役期间性侵犯经历的女性中，26%认可24种症状/状况中的≥12种，而在报告无服役期间性侵犯经历的女性中这一比例为11%（p < 0.001）。临床医生需要留意女性VA使用者报告的服役期间性侵犯的高发生率及其相关的一系列当前身体症状和医疗状况。临床医生应考虑对年轻和年长患者都进行性暴力史筛查，尤其是有多种身体症状的患者。
