Wijma B, Schei B, Swahnberg K, Hilden M, Offerdal K, Pikarinen U, Sidenius K, Steingrimsdottir T, Stoum H, Halmesmäki E
Division of Women's Health, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Lancet. 2003 Jun 21;361(9375):2107-13. doi: 10.1016/s0140-6736(03)13719-1.
Abuse against women causes much suffering for individuals and is a major concern for society. We aimed to estimate the prevalence of three types of abuse in patients visiting gynaecology clinics in five Nordic countries, and to assess the frequency with which gynaecologists identify abuse victims.
We did a cross-sectional, multicentre study of women attending five departments of gynaecology in Denmark, Finland, Iceland, Norway, and Sweden. We recruited 4729 patients; 3641 (77%) responded and were included in the study. Participants completed a postal questionnaire (norvold abuse questionnaire) confidentially. Primary outcome measures were prevalences of emotional, physical, and sexual abuse, and whether abused patients had told their gynaecologist about these experiences. We assessed differences between countries with Pearson's chi(2) test.
The ranges across the five countries of lifetime prevalence were 38-66% for physical abuse, 19-37% for emotional abuse, and 17-33% for sexual abuse. Not all abused women reported current ill-effects from the abusive experience. Most women (92-98%) had not talked to their gynaecologist about their experiences of abuse at their latest clinic visit.
Despite prevalences of emotional, physical, and sexual abuse being high in patients visiting gynaecology clinics in the Nordic countries, most victims of abuse are not identified by their gynaecologists. This lack of discussion might increase the risk of abused patients not being treated according to their needs. Gynaecologists should always consider asking their patients about abuse.
对妇女的虐待给个人带来诸多痛苦,也是社会关注的主要问题。我们旨在估计北欧五个国家妇科门诊患者中三种虐待类型的患病率,并评估妇科医生识别虐待受害者的频率。
我们对丹麦、芬兰、冰岛、挪威和瑞典五个妇科科室的女性进行了一项横断面多中心研究。我们招募了4729名患者;3641名(77%)做出回应并被纳入研究。参与者通过邮寄方式秘密填写一份问卷(诺沃尔德虐待问卷)。主要结局指标为情感虐待、身体虐待和性虐待的患病率,以及受虐待患者是否向其妇科医生讲述过这些经历。我们使用Pearson卡方检验评估各国之间的差异。
五个国家终身患病率的范围分别为:身体虐待38% - 66%,情感虐待19% - 37%,性虐待17% - 33%。并非所有受虐待女性都报告了虐待经历带来的当前不良影响。大多数女性(92% - 98%)在最近一次门诊就诊时未与妇科医生谈论过她们的虐待经历。
尽管北欧国家妇科门诊患者中情感、身体和性虐待的患病率较高,但大多数虐待受害者未被妇科医生识别出来。这种缺乏讨论的情况可能会增加受虐待患者未得到按需治疗的风险。妇科医生应始终考虑询问患者是否遭受过虐待。