Glass N, Dearwater S, Campbell J
Johns Hopkins University School of Nursing, Baltimore, MD 21205.
J Emerg Nurs. 2001 Apr;27(2):141-9. doi: 10.1067/men.2001.114387.
To provide clinical practice recommendations for screening and interventions for intimate partner violence (IPV) in ED settings.
Eleven mid-sized community-level hospital emergency departments (20,000 to 40,000 admissions annually) in Pennsylvania and California.
All women (4641) aged 18 years or older who came to the emergency department during 309 selected shifts.
An anonymous survey inquiring about physical, sexual, and emotional IPV was conducted from 1995 through 1997. In addition, medical records were abstracted for every woman (18 years and older) seen in the 11 participating emergency departments during the study period.
The vast majority of both abused and nonabused women supported routine screening for IPV; however, fewer than 25% of women said they were asked about IPV by ED staff. ED screening rates for IPV were higher among women who came to the emergency department because of acute trauma from abuse (39%) than for women who reported that they had been abused within the past year (13%). The prevalence of past year and lifetime IPV was significantly higher when the questionnaire was self-administered than when it was administered by a nurse. More than a third of women who had recently been abused and 76% of women who acknowledged experiencing physical or sexual IPV within the past year reported that they did not come to the emergency department for treatment of an injury. Although the majority of women (76% to 90%) agreed with the concept of health care providers reporting IPV to the police, women abused recently were significantly less likely to support this practice.
The study provides evidence supporting standard protocols for routine screening for IPV among women who come to emergency departments and chart prompts for both screening and interventions. These actions are acceptable to the majority of both abused and nonabused women seen in the emergency department and should be considered in systematic repeated training of health care professionals in emergency departments. This information is important for health care providers who are seeking to improve their identification of and care for abused women.
为急诊科亲密伴侣暴力（IPV）的筛查和干预提供临床实践建议。
宾夕法尼亚州和加利福尼亚州的11家社区规模的中型医院急诊科（每年收治20000至40000例患者）。
在309个选定班次期间前来急诊科就诊的所有18岁及以上女性（共4641名）。
1995年至1997年进行了一项关于身体、性和情感方面IPV的匿名调查。此外，对研究期间在11家参与研究的急诊科就诊的每名18岁及以上女性的病历进行了摘要分析。
绝大多数受虐和未受虐女性都支持对IPV进行常规筛查；然而，不到25%的女性表示急诊科工作人员询问过她们关于IPV的情况。因虐待导致急性创伤前来急诊科就诊的女性中，IPV的急诊科筛查率（39%）高于那些报告在过去一年中遭受过虐待的女性（13%）。当问卷由患者自行填写时，过去一年和一生遭受IPV的患病率显著高于由护士填写时。超过三分之一最近遭受虐待的女性以及76%承认在过去一年中经历过身体或性方面IPV的女性报告称，她们没有因受伤前来急诊科治疗。尽管大多数女性（76%至90%）同意医疗保健提供者向警方报告IPV的概念，但最近遭受虐待的女性支持这种做法的可能性明显较小。
该研究提供了证据，支持为前来急诊科的女性进行IPV常规筛查的标准方案以及筛查和干预的病历提示。这些措施为急诊科中绝大多数受虐和未受虐女性所接受，应在对急诊科医疗保健专业人员进行系统的重复培训时予以考虑。这些信息对于寻求改善对受虐女性识别和护理的医疗保健提供者来说非常重要。
