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儿科急诊科对亲密伴侣暴力干预的即时和延迟反应:病例报告

Immediate and Late Response to Intimate Partner Violence Intervention in the Pediatric Emergency Department: A Case Report.

作者信息

Randell Kimberly A, Harris Danica, Stallbaumer-Rouyer Jennifer

出版信息

Pediatr Emerg Care. 2018 Mar;34(3):e41-e43. doi: 10.1097/PEC.0000000000000908.

Abstract

Childhood exposure to intimate partner violence (IPV) results in numerous, lifelong, negative health outcomes, underscoring the American Academy of Pediatrics' recommendation for IPV screening and intervention in the pediatric health care setting. We report a case in which a mother denied IPV during routine IPV screening in a pediatric emergency department (ED). However, subsequent discussion with health care providers during the ED visit revealed IPV. The mother declined to meet with an IPV advocate because the abuser was texting repeatedly to ask about the duration of the ED visit. However, the onsite social worker met with the mother to provide supportive counseling and complete safety assessment and planning. The mother returned to the abusive home after ED discharge because 3 of her 4 children were with the abuser at that time. Four months later, the mother returned to the ED with her children to see the IPV advocate. After speaking with the advocate, the mother and children went to safe shelter directly from the ED. This case underscores the importance of providing caregivers with multiple opportunities to disclose IPV, the need for health care providers to remain alert to indications that IPV may be occurring, and the role of the entire health care team in addressing IPV. This case also demonstrates that although IPV interventions may not immediately result in leaving an abusive relationship, the unseen benefits of such education and support can ultimately improve safety.

摘要

童年时期接触亲密伴侣暴力(IPV)会导致众多长期的负面健康后果,这突出了美国儿科学会关于在儿科医疗环境中进行IPV筛查和干预的建议。我们报告了一个案例,在一家儿科急诊科(ED)进行常规IPV筛查时,一位母亲否认存在IPV。然而,在急诊就诊期间随后与医护人员的讨论揭示了IPV情况。这位母亲拒绝与IPV倡导者会面,因为施虐者不断发短信询问急诊就诊的时长。不过,现场的社会工作者与这位母亲会面,提供支持性咨询并完成安全评估和规划。急诊出院后,这位母亲回到了受虐的家中,因为当时她的4个孩子中有3个与施虐者在一起。四个月后,这位母亲带着孩子再次来到急诊室见IPV倡导者。与倡导者交谈后,这位母亲和孩子直接从急诊室前往了安全庇护所。这个案例强调了为照顾者提供多次披露IPV机会的重要性,医护人员需要对可能发生IPV的迹象保持警惕,以及整个医疗团队在应对IPV方面的作用。这个案例还表明,尽管IPV干预可能不会立即导致离开虐待关系,但这种教育和支持的潜在益处最终可以提高安全性。

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