Usta Jinan, Feder Gene, Antoun Jumana
Department of Family Medicine, American University of Beirut, Lebanon, Beirut.
School of Social and Community Medicine, University of Bristol, Bristol, UK.
Br J Gen Pract. 2014 Jun;64(623):e313-20. doi: 10.3399/bjgp14X680077.
Domestic violence (DV) is highly prevalent in the developing and developed world. Healthcare systems internationally are still not adequately addressing the needs of patients experiencing violence.
To explore physicians' attitudes about responding to DV, their perception of the physician's role, and the factors that influence their response.
Qualitative study using individual interviews among primary care practitioners working in Lebanon.
Primary care clinicians practising for >5 years and with >100 patient consultations a week were interviewed. Physicians were asked about their practice when encountering women disclosing abuse, their opinion about the engagement of the health services with DV, their potential role, and the anticipated reaction of patients and society to this extended role.
Physicians felt that they were well positioned to play a pivotal role in addressing DV; yet they had concerns related to personal safety, worry about losing patients, and opposing the norms of a largely conservative society. Several physicians justified DV or blamed the survivor rather than the perpetrator for triggering the violent behaviour. Moreover, religion was perceived as sanctioning DV.
Perceived cultural norms and religious beliefs seem to be major barriers to physicians responding to DV in Lebanon, and possibly in the Arab world more generally. Financial concerns also need to be addressed to encourage physicians to address DV.
家庭暴力在发展中国家和发达国家都极为普遍。国际医疗保健系统仍未充分满足遭受暴力侵害患者的需求。
探讨医生对应对家庭暴力的态度、他们对医生角色的认知以及影响其应对的因素。
采用定性研究方法，对黎巴嫩的基层医疗从业者进行个人访谈。
对从业超过5年且每周诊疗患者超过100人次的基层医疗临床医生进行访谈。询问医生在遇到女性披露受虐情况时的做法、他们对医疗服务介入家庭暴力的看法、他们可能发挥的作用以及患者和社会对这一扩展角色的预期反应。
医生们认为他们在应对家庭暴力方面处于有利地位，能够发挥关键作用；然而，他们担心个人安全、担心失去患者，并且反对一个大体保守社会的规范。一些医生为家庭暴力辩解，或将暴力行为的引发归咎于幸存者而非施暴者。此外，宗教被视为对家庭暴力的认可。
在黎巴嫩，可能在更广泛的阿拉伯世界，公认的文化规范和宗教信仰似乎是医生应对家庭暴力的主要障碍。还需要解决经济方面的担忧，以鼓励医生应对家庭暴力。
