Chen Ping-Hsin, Jacobs Abbie, Rovi Susan L D
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, 183 South Orange Avenue BHSB-E1557, Newark, NJ 07103,
FP Essent. 2013 Sep;412:18-23.
The family physician's office is a potentially safe place to discuss intimate partner violence (IPV). RADAR (Remember to ask routinely, Ask directly [in private], Document findings, Assess safety, Review options) is a tool for identifying and responding to IPV. Physicians should ask permission to document abuse, consider using a body map, and ensure confidentiality. They should also assess immediate safety by asking about weapons in the home, children's safety, and the likelihood that the perpetrator will harm him- or herself or others. Federal privacy laws require physicians to inform patients about health information disclosure. Because mandatory reporting varies by state, physicians should communicate clearly the office's responsibilities. Interventions are based on an advocacy model that requires appropriate training and establishment of links to community-based resources. Brief advocacy includes providing information cards, whereas intensive intervention includes IPV education, danger assessment, prevention options, safety planning, and community referrals. The Stages of Change Model may help physicians understand a patient's readiness and ability to make a change. For the IPV survivor who has left an abusive partner, physicians should be aware of the challenges of safety, health, legal, and financial issues; protection orders are a possible safety strategy. The most common intervention for perpetrators is a batterer intervention program. Couples counseling by family physicians is contraindicated.
家庭医生办公室是一个讨论亲密伴侣暴力（IPV）的潜在安全场所。RADAR（记得定期询问、直接[私下]询问、记录发现、评估安全性、审查选项）是一种识别和应对亲密伴侣暴力的工具。医生应在记录虐待情况前征得同意，考虑使用身体图谱，并确保保密性。他们还应通过询问家中是否有武器、儿童安全情况以及施暴者伤害自己或他人的可能性来评估即时安全性。联邦隐私法要求医生告知患者有关健康信息披露的情况。由于强制报告因州而异，医生应明确说明办公室的职责。干预措施基于一种倡导模式，这需要适当的培训并建立与社区资源的联系。简短倡导包括提供信息卡，而深入干预包括亲密伴侣暴力教育、危险评估、预防选项、安全规划和社区转介。改变阶段模型可能有助于医生了解患者做出改变的准备情况和能力。对于已经离开虐待伴侣的亲密伴侣暴力幸存者，医生应意识到安全、健康、法律和财务问题方面的挑战；保护令是一种可能的安全策略。对施暴者最常见的干预措施是施暴者干预项目。家庭医生进行夫妻咨询是禁忌的。
