Department of Community and Family Medicine, Howard University College of Medicine, 520 W Street NW, Washington, DC 20059, USA.
Ann Fam Med. 2010 May-Jun;8(3):206-13. doi: 10.1370/afm.1095.
The purpose of this study was to examine the psychological effects of physical and verbal abuse in a cohort of older women.
This observational cohort study was conducted at 40 clinical sites nationwide that are part of the Women's Health Initiative (WHI) Observational Study. We surveyed 93,676 women aged 50 to 79 years using the mental health subscales and the combined mental component summary (MCS) score of the RAND Medical Outcomes Study 36-item instrument.
At baseline, women reporting exposure to physical abuse only, verbal abuse only, or both physical and verbal abuse had a greater number of depressive symptoms (1.6,1.6, and 3 more symptoms, respectively) and lower MCS scores (4.6, 5.4, and 8.1 lower scores, respectively) than women not reporting abuse. Compared with women who had no exposure to abuse, women had a greater increase in the number of depressive symptoms when they reported a 3-year incident exposure to physical abuse only (0.2; 95% confidence interval [CI], -0.21 to 0.60), verbal abuse only (0.18; 95% CI, 0.11 to 0.24), or both physical and verbal abuse (0.15; 95% CI, -0.05 to 0.36); and they had a decrease in MCS scores when they reported a 3-year incident exposure to physical abuse only (-1.12; 95% CI, -2.45 to 0.12), verbal abuse only (-0.55; 95% CI, -0.75 to -0.34), and both physical and verbal abuse (-0.44; 95% CI, -1.11 to -0.22) even after adjustment for sociodemographic characteristics.
Exposure to abuse in older, functionally independent women is associated with poorer mental health. The persistence of these findings suggests that clinicians need to consider abuse exposure in their older female patients who have depressive symptoms. Clinicians caring for older women should identify women at risk for physical and verbal abuse and intervene appropriately.
本研究旨在调查身体和言语虐待对一组老年女性的心理影响。
本观察性队列研究在全国 40 个临床站点进行，这些站点是妇女健康倡议（WHI）观察研究的一部分。我们使用 RAND 医疗结果研究 36 项工具的心理健康子量表和综合心理成分综合得分（MCS）对 93676 名年龄在 50 至 79 岁的女性进行了调查。
在基线时，仅报告遭受身体虐待、仅报告言语虐待或同时遭受身体和言语虐待的女性出现更多抑郁症状（分别为 1.6、1.6 和 3 个症状）和更低的 MCS 得分（分别为 4.6、5.4 和 8.1 分）比不报告虐待的女性。与没有遭受虐待的女性相比，报告发生 3 年的身体虐待仅（0.2；95%置信区间[CI]，-0.21 至 0.60）、言语虐待仅（0.18；95% CI，0.11 至 0.24）或同时遭受身体和言语虐待（0.15；95% CI，-0.05 至 0.36）的女性抑郁症状数有更大的增加；而报告发生 3 年的身体虐待仅（-1.12；95% CI，-2.45 至 0.12）、言语虐待仅（-0.55；95% CI，-0.75 至 -0.34）或同时遭受身体和言语虐待（-0.44；95% CI，-1.11 至 -0.22）的女性 MCS 得分有下降，即使在调整了社会人口特征后也是如此。
在功能独立的老年女性中，遭受虐待与心理健康状况较差有关。这些发现的持续存在表明，临床医生需要考虑在有抑郁症状的老年女性患者中考虑虐待暴露情况。照顾老年女性的临床医生应识别有身体和言语虐待风险的女性，并进行适当干预。
