Gerbert Barbara, Moe James, Caspers Nona, Salber Patricia, Feldman Mitchell, Herzig Karen, Bronstone Amy
Division of Behavioral Sciences, University of California San Francisco, 94117, USA.
Women Health. 2002;35(2-3):1-22. doi: 10.1300/J013v35n02_01.
Even though current domestic violence guidelines, such as those published by the AMA in 1992, attempt to relieve physicians of the "full burden of intervention," they continue to call upon physicians to play a large role in identifying, intervening in, and following up on case of partner abuse. In this paper, we define a limited domestic violence role for physicians which furthers the direction recommended by the AMA and which complements exemplary programs. We propose simplifying and limiting physicians' tasks to Asking patients about abuse; providing Validating messages, acknowledging that battering is wrong and confirming patient worth; Documenting presenting signs, symptoms, and disclosures; and Referring victims to domestic violence specialists (AVDR). By drawing on the literature and our own experience, we show how focusing the physician's role on these four taks is consistent with exemplary programs and expands on ideas put forth by experts for addressing domestic violence in health care settings; reduces barriers for physician interventions with victims; offers a realistic approach for physicians, reducing unrealistic educational demands; and complements managed care trends in contemporary health care.
尽管当前的家庭暴力指南，如美国医学协会1992年发布的那些指南，试图减轻医生的“全面干预负担”，但它们仍要求医生在识别、干预和跟进伴侣虐待案件中发挥重要作用。在本文中，我们为医生定义了一个有限的家庭暴力角色，这进一步推进了美国医学协会推荐的方向，并补充了模范项目。我们建议简化并限制医生的任务为：询问患者是否遭受虐待；提供确认信息，承认殴打是错误的并确认患者的价值；记录呈现的体征、症状和披露的情况；以及将受害者转介给家庭暴力专家（AVDR）。通过借鉴文献和我们自己的经验，我们展示了将医生的角色集中在这四项任务上如何与模范项目相一致，并扩展了专家们提出的在医疗环境中解决家庭暴力问题的想法；减少医生对受害者进行干预的障碍；为医生提供一种现实的方法，减少不切实际的教育要求；并补充当代医疗保健中的管理式护理趋势。
