Lo Fo Wong Sylvie, Wester Fred, Mol Saskia S L, Lagro-Janssen Toine L M
Raboud University Medical Centre, Department of Family Medicine/Women's Studies Medical Sciences, Nijmegen, The Netherlands.
Br J Gen Pract. 2006 Apr;56(525):249-57.
Intimate partner abuse is very common among female patients in family practice. In general, doctors overlook the possibility of partner abuse.
To investigate whether awareness of intimate partner abuse, as well as active questioning, increase after attending focus group and training, or focus group only.
Randomised controlled trial in a stratified sample.
Family practices in Rotterdam and surrounding areas.
A full-training group (n = 23), a group attending focus group discussions alone (n = 14), and a control group (n = 17) were formed. Data were collected with incident reporting of every female patient (aged >18 years) that was suspected of, or presented, partner abuse during a period of 6 months. The primary outcome measure was the number of reported patients; the secondary outcome measure was the number of patients with whom the GP had non-obvious reasons to suspect/discuss abuse.
Comparison of the full-training group (n = 87 patients) versus the control group (n = 14 patients) resulted in a rate ratio of 4.54 (95% confidence interval [CI] = 2.55 to 8.09, P <0.001); the focus group only group (n = 30 cases) versus control group: rate ratio of 2.2 (95% CI = 1.14 to 4.26, P = 0.019); full-training versus the focus group only group: rate ratio of 2.19 (95% CI = 1.36 to 3.52, P = 0.001). Comparison of the fulltraining group with the untrained groups for awareness of partner abuse in case of non-obvious signs resulted in: odds ratio 5.92 (95% CI = 2.25 to 15.62, P <0.01) all corrected for sex, district, practice setting, working part/full-time, experience, and age of the doctor.
Training was the most significant determinant to improve awareness and identification of intimate partner abuse. Active questioning increased, especially where there were non-obvious signs. The focus group on its own doubled the awareness of partner abuse.
亲密伴侣虐待在家庭医疗中的女性患者中非常普遍。一般来说，医生会忽视伴侣虐待的可能性。
调查参加焦点小组和培训后，或者仅参加焦点小组后，对亲密伴侣虐待的认知以及主动询问的情况是否会增加。
分层抽样的随机对照试验。
鹿特丹及周边地区的家庭医疗诊所。
组建了一个全面培训组（n = 23）、一个仅参加焦点小组讨论的组（n = 14）和一个对照组（n = 17）。收集了在6个月期间每一位被怀疑遭受或报告遭受伴侣虐待的18岁以上女性患者的事件报告数据。主要结局指标是报告的患者数量；次要结局指标是全科医生无明显理由怀疑/讨论虐待行为的患者数量。
全面培训组（n = 87例患者）与对照组（n = 14例患者）相比，率比为4.54（95%置信区间[CI] = 2.55至8.09，P <0.001）；仅参加焦点小组的组（n = 30例）与对照组相比：率比为2.2（95%CI = 1.14至4.26，P = 0.019）；全面培训组与仅参加焦点小组的组相比：率比为2.19（95%CI = 1.36至3.52，P = 0.001）。全面培训组与未培训组在非明显迹象情况下对伴侣虐待的认知比较结果为：优势比5.92（95%CI = 2.25至15.62，P <0.01），所有结果均针对医生的性别、地区、执业环境、工作兼职/全职、经验和年龄进行了校正。
培训是提高对亲密伴侣虐待的认知和识别能力的最重要决定因素。主动询问有所增加，尤其是在没有明显迹象的情况下。仅焦点小组就使对伴侣虐待的认知提高了一倍。
