Bullock Linda, Bloom Tina, Davis Jan, Kilburn Erin, Curry Mary Ann
Linda F. C. Bullock, RN, PhD, FAAN, is Associate Professor, University of Missouri-Columbia, Sinclair School of Nursing.Tina Bloom, RN, MPH, is a doctoral student at Oregon Health & Science University School of Nursing.Jan Davis, RN, BS, is a Research Nurse, University of Missouri-Columbia, Sinclair School of Nursing.Erin Kilburn, RN, MS, is a doctoral student at the University of Missouri-Columbia, Sinclair School of Nursing.Mary Ann Curry, RN, DNSc, is Professor Emeritus, Oregon Health & Science University School of Nursing.
J Midwifery Womens Health. 2006 Sep-Oct;51(5):361-369. doi: 10.1016/j.jmwh.2006.02.012.
Disclosure of abuse by pregnant women can vary depending on whether the woman is assessed directly by a trained interviewer versus written questionnaires, and if she is asked repeatedly during the course of pregnancy. One thousand pregnant women were enrolled in a randomized clinical trial designed to assess the effects of a nursing case management intervention on the mental and physical well-being of pregnant women experiencing or at risk for abuse. Thirteen percent of the total study participants reported current abuse and/or abuse within the past year, with only 2% of those reporting that the abuse occurred during pregnancy. The incidence of reported abuse was much higher among Medicaid-funded women (28.9%) than privately insured women (8.7%). Regardless of source of payment, women reporting abuse were significantly younger, less educated, nonwhite with lower income, and had significantly higher stress and lower self-esteem than women not reporting abuse. A high incidence of women reporting intimate partner violence described being choked on the Danger Assessment Screen (34%). We strongly urge that choking be added to routine screening questions used during pregnancy and that the Danger Assessment tool is used for further evaluation of women who screen positive. In addition, we believe another barrier to reporting abuse was fear of being reported to child protective services, contributing to the overall low rate of abuse disclosure.
孕妇对虐待行为的披露情况可能因多种因素而有所不同，比如孕妇是由经过培训的访谈者直接评估还是通过书面问卷进行评估，以及在孕期是否被反复询问。一千名孕妇参与了一项随机临床试验，该试验旨在评估护理个案管理干预措施对遭受虐待或有虐待风险的孕妇身心健康的影响。在所有研究参与者中，13%报告称目前正在遭受虐待和/或在过去一年中遭受过虐待，其中只有2%的人报告虐待行为发生在孕期。医疗补助资助的女性中报告的虐待发生率（28.9%）远高于私人保险女性（8.7%）。无论支付来源如何，报告遭受虐待的女性明显更年轻、受教育程度更低、非白人且收入较低，与未报告遭受虐待的女性相比，她们的压力明显更大，自尊水平更低。在危险评估筛查中，报告亲密伴侣暴力的女性中有很高比例（34%）称曾被掐住脖子。我们强烈敦促将掐脖子行为纳入孕期常规筛查问题，并使用危险评估工具对筛查呈阳性的女性进行进一步评估。此外，我们认为报告虐待行为的另一个障碍是担心被报告给儿童保护服务机构，这导致了虐待披露率总体较低。
