Varjavand Nielufar, Cohen Diane G, Gracely Edward J, Novack Dennis H
Drexel University College of Medicine, USA.
J Am Med Womens Assoc (1972). 2004 Winter;59(1):48-53.
We conducted this study to identify residents' limitations in screening for, documenting, and managing domestic violence (DV) and to focus future educational interventions.
We administered a detailed survey to 103 internal medicine residents from 4 university-affiliated programs to ascertain their attitudes about and practices in screening for, documenting, and managing DV.
Most residents agreed that DV is a significant health care problem (87%) and one in which physicians can intervene effectively (77%), yet 37% reported not screening for DV. Residents who said they do not screen reported a variety of mitigating factors, from uncertainty about how to screen for and manage DV, to fear of insulting or angering the patient. Eighty-two percent stated that they would document DV in the chart, but 51% had reasons for not documenting DV, ranging from fear that the patient's partner might harm the patient or the physician to concern that the patient may not be telling the truth. Fifty-seven percent of residents said they would ask about DV more often if state law mandated it. When asked to choose which management interventions were helpful or unhelpful, many residents made incorrect, potentially injurious choices.
Many residents reported beliefs and practices that could inhibit optimal care of DV victims. Educational interventions should be directed at remedying residents' gaps in knowledge and attitudes to improve screening for, documenting, and managing DV.
我们开展这项研究以确定住院医师在筛查、记录和处理家庭暴力（DV）方面的局限性，并为未来的教育干预措施指明方向。
我们对来自4个大学附属医院项目的103名内科住院医师进行了详细调查，以确定他们在筛查、记录和处理DV方面的态度和做法。
大多数住院医师认同DV是一个重大的医疗保健问题（87%），且医生能够有效干预（77%），然而37%的住院医师报告未对DV进行筛查。表示不进行筛查的住院医师列举了各种缓解因素，从对如何筛查和处理DV的不确定，到担心侮辱或激怒患者。82%的住院医师表示会在病历中记录DV，但51%的人有不记录的理由，包括担心患者的伴侣可能伤害患者或医生，以及担心患者可能没有说实话。57%的住院医师表示，如果州法律强制要求，他们会更频繁地询问DV情况。当被要求选择哪些处理干预措施有用或无用时，许多住院医师做出了错误的、可能有害的选择。
许多住院医师报告的观念和做法可能会妨碍对DV受害者的最佳护理。教育干预应旨在弥补住院医师在知识和态度方面的差距，以改善对DV的筛查、记录和处理。
