Centre for Public Health, Liverpool John Moores University, UK.
Lancet. 2012 Apr 28;379(9826):1621-9. doi: 10.1016/S0140-6736(11)61851-5. Epub 2012 Feb 28.
About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.
In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.
Of 10,663 references initially identified, 26 were eligible for inclusion, with data for 21,557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3-31·0) in people with mental illnesses, 6·1% (2·5-11·1) in those with intellectual impairments, and 3·2% (2·5-4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I(2) >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09-2·05) for all studies combined, 1·31 (0·93-1·84) for people with non-specific impairments, 1·60 (1·05-2·45) for people with intellectual impairments, and 3·86 (0·91-16·43) for those with mental illnesses.
Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.
WHO Department of Violence and Injury Prevention and Disability.
全世界约有 15%的成年人存在残疾。据报道，这些人遭受暴力的风险更高，然而定量综合研究这一问题的研究很少。我们旨在量化针对残疾成年人的暴力行为。
在这项系统评价和荟萃分析中，我们检索了 12 个电子数据库，以确定发表于 1990 年 1 月 1 日至 2010 年 8 月 17 日之间的主要研究报告，这些报告报告了残疾成年人（主要为≥18 岁）遭受暴力的流行率估计值，或与非残疾成年人相比，他们遭受暴力的风险。我们仅纳入了报告在研究前 12 个月内发生的暴力事件的研究。我们使用六项核心质量标准评估了研究，并对数据进行了汇总分析。
在最初确定的 10663 条参考文献中，有 26 条符合纳入标准，涉及 21557 名残疾成年人的数据。21 项研究提供了适合进行暴力流行率荟萃分析的数据，10 项研究提供了暴力风险荟萃分析的数据。患有精神疾病的人最近发生任何形式（身体、性或亲密伴侣）暴力的合并流行率为 24.3%（95%CI 18.3-31.0），智力障碍者为 6.1%（2.5-11.1），非特定障碍者为 3.2%（2.5-4.1）。我们发现大多数流行率估计值存在很大的异质性（I(2) >75%）。我们注意到汇总风险估计值存在很大的不确定性。残疾与非残疾个体相比，暴力风险的汇总粗比值比为 1.50（95%CI 1.09-2.05），非特定障碍者为 1.31（0.93-1.84），智力障碍者为 1.60（1.05-2.45），精神疾病患者为 3.86（0.91-16.43）。
与非残疾成年人相比，残疾成年人遭受暴力的风险更高，而患有精神疾病的成年人可能尤其脆弱。然而，现有研究存在方法学上的缺陷，并且它们所涉及的残疾类型和暴力类型存在空白。大多数地区，尤其是低收入和中等收入国家，缺乏可靠的研究。
世界卫生组织暴力和伤害预防与残疾部。
