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风险不止于暴力:农村一级创伤中心收治女性的亲密伴侣暴力、精神疾病与药物滥用之间的关联

Risks go beyond the violence: Association between intimate partner violence, mental illness, and substance abuse among females admitted to a rural Level I trauma center.

作者信息

Hink Ashley B, Toschlog Eric, Waibel Brett, Bard Michael

机构信息

From the Division of General Surgery (A.B.H.), Department of Surgery, Medical University of South Carolina, Charleston; and Division of Trauma and Surgical Critical Care (E.T., B.W., M.B.), Department of General Surgery, The Brody School of Medicine at East Carolina University, Greenville, South Carolina.

出版信息

J Trauma Acute Care Surg. 2015 Nov;79(5):709-14; discussion 715-6. doi: 10.1097/TA.0000000000000856.

Abstract

BACKGROUND

Intimate partner violence (IPV) is a significant cause of intentional injury among women but remains underrecognized, and its relationship to other risk factors for all-cause injury remains poorly defined. This study aimed to assess IPV and its association with alcohol abuse, illicit substance use, selected mental illnesses, and other risk factors for injury.

METHODS

This is a cross-sectional study of prospectively collected data among adult females admitted to a rural, Level I trauma center. Well-validated instruments assessed IPV, substance abuse, and mental illness. Bivariate relationships were assessed with χ, odds ratios, and t test analyses.

RESULTS

Eighty-one women were enrolled; 51% reported lifetime IPV, and 31% reported past-year IPV. Both groups were significantly more likely to have a mental illness than those without a history of IPV. Those reporting lifetime IPV exposure were significantly more likely to report illicit substance use, and past-year IPV was associated with alcohol abuse (28% vs. 7.1%, p = 0.01). Participants reporting past-year IPV were significantly more likely to have a partner possessing a firearm (40% vs. 12.5%, p = 0.005).

CONCLUSION

The experience of lifetime and past-year IPV among women at a Level I, rural trauma center was high, and it was significantly associated with mental illness, substance abuse, and high-risk scenarios for intentional injury including firearm ownership by a significant other. These findings inform the potential value of IPV screening and intervention and suggest that IPV, mental illness, and substance abuse should be considered associated entities in prevention and recidivism reduction efforts in the female trauma population.

LEVEL OF EVIDENCE

Prognostic study, level II; therapeutic study, level III.

摘要

背景

亲密伴侣暴力(IPV)是女性故意伤害的一个重要原因,但仍未得到充分认识,其与全因伤害的其他风险因素之间的关系也仍未明确界定。本研究旨在评估亲密伴侣暴力及其与酒精滥用、非法药物使用、特定精神疾病以及其他伤害风险因素之间的关联。

方法

这是一项对前瞻性收集的、入住农村一级创伤中心的成年女性数据进行的横断面研究。采用经过充分验证的工具评估亲密伴侣暴力、药物滥用和精神疾病。通过χ检验、比值比和t检验分析评估双变量关系。

结果

共纳入81名女性;51%报告有终身亲密伴侣暴力经历,31%报告过去一年有亲密伴侣暴力经历。与没有亲密伴侣暴力史的女性相比,这两组女性患精神疾病的可能性均显著更高。报告有终身亲密伴侣暴力暴露经历的女性报告非法药物使用的可能性显著更高,过去一年的亲密伴侣暴力与酒精滥用有关(28%对7.1%,p = 0.01)。报告过去一年有亲密伴侣暴力经历的参与者其伴侣拥有枪支的可能性显著更高(40%对12.5%,p = 0.005)。

结论

在农村一级创伤中心,女性终身和过去一年亲密伴侣暴力的发生率较高,且与精神疾病、药物滥用以及故意伤害的高风险情况显著相关,包括重要他人拥有枪支。这些发现说明了亲密伴侣暴力筛查和干预的潜在价值,并表明在女性创伤人群的预防和减少再犯努力中,亲密伴侣暴力、精神疾病和药物滥用应被视为相关联的实体。

证据水平

预后研究,二级;治疗研究,三级。

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