Roelens Kristien, Verstraelen Hans, Van Egmond Kathia, Temmerman Marleen
Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Ghent University, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
Eur J Obstet Gynecol Reprod Biol. 2008 Mar;137(1):37-42. doi: 10.1016/j.ejogrb.2007.04.013. Epub 2007 Jun 1.
The objectives were to estimate the prevalence of physical and sexual intimate partner violence (IPV) among a regional sample of the general obstetric population as the lifetime prevalence, as the 1-year period prevalence before pregnancy, and as the prevalence during the index pregnancy; to assess the rates of disclosure and help-seeking behaviour with IPV; and to determine the acceptability of screening for IPV.
A multi-centred survey surveillance study was carried out among pregnant women attending five large hospitals in the province of East Flanders, Belgium as a regional probability sample of the general obstetric population. Data were collected through an anonymous, written questionnaire that included the Abuse Assessment Screen and additional questions on the circumstances of the most recent episode of physical or sexual violence, on disclosure and help-seeking behaviour, on reporting assault to the police, and on the acceptability of routine screening for IPV.
The sampling frame consisted of 1362 women who received the questionnaire at the antenatal service during a 2-month study period, of which 537 (mean age 29.4 years, S.D. 4.09) returned the envelope (response rate 39.4%). The lifetime prevalence of IPV was estimated to be 10.1% (95% CI 7.7-13.0%) and the period prevalence of IPV during pregnancy and/or in the year preceding pregnancy 3.4% (95% CI 2.1-5.4%). There was a significant difference in the reported lifetime prevalence of IPV between women attending with a partner and those who came to the prenatal visit unattended by their partner in particular (6.8% versus 13.9%, p=0.010). Overall, only 19.2% (23 out of 120) and as few as 6.6% (4 out of 61) of the victims of physical and sexual abuse respectively sought medical care by consulting a general practitioner, gynaecologist, or an emergency department. Routine screening for IPV by a general practitioner or gynaecologist was found to be largely acceptable.
In our highly medicalised society, women experiencing partner violence rarely disclose abuse to the widely available health care services, unless they are directly asked about it, which appears an acceptable practice. Hence, there is a definite need to improve women's awareness regarding abuse and their help-seeking behaviour at a public health level.
本研究旨在估计普通产科人群区域样本中身体暴力和性暴力亲密伴侣暴力（IPV）的终生患病率、怀孕前1年期间的患病率以及本次怀孕期间的患病率；评估IPV的披露率和求助行为；并确定IPV筛查的可接受性。
在比利时东佛兰德省的五家大型医院对孕妇进行了一项多中心调查监测研究，作为普通产科人群的区域概率样本。通过一份匿名书面问卷收集数据，问卷包括虐待评估筛查以及关于最近一次身体或性暴力事件的情况、披露和求助行为、向警方报告袭击事件以及IPV常规筛查的可接受性等额外问题。
抽样框架包括1362名在为期2个月的研究期间在产前服务中收到问卷的女性，其中537名（平均年龄29.4岁，标准差4.09）返还了信封（回复率39.4%）。IPV的终生患病率估计为10.1%（95%可信区间7.7 - 13.0%），怀孕期间和/或怀孕前一年IPV的期间患病率为3.4%（95%可信区间2.1 - 5.4%）。特别是有伴侣陪同前来的女性和无伴侣陪同前来产前检查的女性在报告的IPV终生患病率上存在显著差异（分别为6.8%和13.9%，p = 0.010）。总体而言，身体虐待和性虐待的受害者中分别只有19.2%（120人中的23人）和低至6.6%（61人中的4人）通过咨询全科医生、妇科医生或急诊科寻求医疗护理。全科医生或妇科医生对IPV进行常规筛查在很大程度上是可接受的。
在我们这个高度医疗化的社会中，遭受伴侣暴力的女性很少向广泛可得的医疗服务机构披露虐待情况，除非直接被问及，而这似乎是一种可接受的做法。因此，在公共卫生层面明确需要提高女性对虐待的认识及其求助行为。
