Spangaro Jo
School of Social Sciences, UNSW Australia, Sydney, NSW 2052, Australia. Email.
Aust Health Rev. 2017 Dec;41(6):639-645. doi: 10.1071/AH16155.
Objective The aim of the present study was to review and analyse academic literature and program evaluations to identify promising evidence for health system responses to domestic violence in Australia and internationally. Methods English-language literature published between January 2005 and March 2016 was retrieved from search results using the terms 'domestic violence' or 'intimate partner violence' in different combinations with other relevant terms, resulting in 1671 documents, of which 59 were systematic reviews. Electronic databases (Medline (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psycinfo, Social work Abstracts, Informit, Violence and Abuse Abstracts, Family Studies Abstracts, Cochrane Library of Systematic Reviews and EMBASE) were searched and narrative analysis undertaken. Results This review details the evidence base for the following interventions by health services responding to domestic violence: first-line responses, routine screening, risk assessment and safety planning, counselling with women, mother-child interventions, responses to perpetrators, child protection notifications, training and system-level responses. Conclusions There is growing evidence for the effectiveness of health service interventions to reduce the extent of harm caused by domestic violence. What is known about the topic? Domestic violence is a significant problem globally with enormous human, social and economic costs. Although women who have experienced abuse make extensive use of healthcare services, health services have lagged behind the policing, criminal justice and other human service domains in responding to domestic violence. What does this paper add? The present comprehensive review identifies best-practice health system responses to domestic violence. What are the implications for practitioners? Health systems can play a key role in identifying and responding to domestic violence for women who often do not access other services. There is growing evidence for the effectiveness of health service interventions to reduce the extent of harm caused by domestic violence, in particular for specialist counselling, structured risk assessment and safety planning, training for first-line responses and interventions for mothers and children affected by domestic violence.
目的 本研究旨在回顾和分析学术文献及项目评估，以确定澳大利亚及国际上卫生系统应对家庭暴力的有效证据。方法 检索2005年1月至2016年3月期间发表的英文文献，使用“家庭暴力”或“亲密伴侣暴力”与其他相关术语的不同组合进行搜索，共得到1671篇文献，其中59篇为系统评价。检索了电子数据库（医学文献数据库（Ovid）、护理及相关健康文献累积索引（CINAHL）、心理学文摘数据库、社会工作文摘数据库、Informit、暴力与虐待文摘数据库、家庭研究文摘数据库、Cochrane系统评价图书馆和EMBASE）并进行了叙述性分析。结果 本综述详细阐述了卫生服务机构应对家庭暴力的以下干预措施的证据基础：一线应对、常规筛查、风险评估与安全规划、为女性提供咨询、母婴干预、对施暴者的应对、儿童保护通报、培训及系统层面的应对。结论 越来越多的证据表明，卫生服务干预措施在减少家庭暴力造成的伤害程度方面是有效的。关于该主题已知的情况是什么？家庭暴力是全球范围内的一个重大问题，会带来巨大的人力、社会和经济成本。尽管遭受虐待的女性广泛利用医疗保健服务，但卫生服务机构在应对家庭暴力方面落后于警务、刑事司法和其他人类服务领域。本文补充了什么内容？本全面综述确定了卫生系统应对家庭暴力的最佳实践。对从业者有何启示？卫生系统在识别和应对家庭暴力方面可以发挥关键作用，因为遭受家庭暴力的女性往往无法获得其他服务。越来越多的证据表明，卫生服务干预措施在减少家庭暴力造成的伤害程度方面是有效的，特别是对于专科咨询、结构化风险评估与安全规划、一线应对培训以及对受家庭暴力影响的母亲和儿童的干预。
