Chamberlain Linda, Perham-Hester Katherine A
Alaska Family Violence Prevention Project, Section of Maternal, Child and Family Health, Department of Health and Social Services, Anchorage 99524-0249, USA.
Women Health. 2002;35(2-3):55-69. doi: 10.1300/J013v35n02_04.
Our purpose was to examine primary care physicians' screening practices for female partner abuse in different clinical situations and to investigate the relationship between perceived barriers and screening practices.
A cross-sectional survey was mailed to Alaska physicians practicing in the following specialties: family practice, internal medicine, obstetrics/gynecology and general practice.
The survey response rate was 80 percent (305/383). The majority (85.7%) of primary care physicians screened often or always when a female patient presents with an injury, but they rarely screened at initial visits (6.2%) or annual exams (7.5%). More than one-third of respondents estimated that 10% or more of their female patients had experienced some type of intimate partner abuse. Several barriers to screening described in the literature were not predictive of physicians' screening practice patterns. Physicians' perceptions that abuse is prevalent among their patients and physicians' beliefs that they have a responsibility to deal with abuse were the only variables independently associated with screening at initial visits and annual exams. The only variable predictive of screening when a patient presents with an injury was physicians' perceived prevalence of abuse.
Primary care physicians have not integrated screening for partner abuse into routine care. Strategies to increase awareness of the high prevalence of abuse in the primary care setting and to educate providers on the negative health effects of victimization can help physicians to acknowledge their responsibility in addressing abuse and the importance of screening at routine visits. Further rigorous studies are needed to identify and evaluate predictors of screening for abuse.
我们的目的是研究初级保健医生在不同临床情况下对女性伴侣虐待的筛查做法，并调查感知到的障碍与筛查做法之间的关系。
向阿拉斯加从事以下专业的医生邮寄了一份横断面调查问卷：家庭医学、内科、妇产科和普通科。
调查回复率为80%（305/383）。大多数初级保健医生（85.7%）在女性患者受伤就诊时经常或总是进行筛查，但在初次就诊（6.2%）或年度体检时很少进行筛查（7.5%）。超过三分之一的受访者估计，他们10%或更多的女性患者曾遭受过某种形式的亲密伴侣虐待。文献中描述的几种筛查障碍并不能预测医生的筛查实践模式。医生认为虐待在患者中普遍存在以及医生认为他们有责任处理虐待问题，是仅与初次就诊和年度体检时的筛查独立相关的变量。唯一能预测患者受伤就诊时进行筛查的变量是医生感知到的虐待普遍程度。
初级保健医生尚未将伴侣虐待筛查纳入常规护理。提高对初级保健环境中虐待高发率的认识以及对医疗服务提供者进行关于受害对健康负面影响的教育的策略，可以帮助医生认识到他们在处理虐待问题中的责任以及常规就诊时筛查的重要性。需要进一步进行严格研究以确定和评估虐待筛查的预测因素。
