Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Science, Tehran, Iran.
Social Determinants of Health Research Center, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Science, Tabriz, Iran.
PLoS One. 2021 Dec 31;16(12):e0261460. doi: 10.1371/journal.pone.0261460. eCollection 2021.
Domestic violence (DV) is a universal issue and an important public health priority. Establishing a DV Registry System (DVRS) can help to systematically integrate data from several sources and provide valid and reliable information on the scope and severity of harms. The main objective of this study was to develop, validate, and pilot-test a minimum datasheet for a DVRS to register DV victims in medical facilities.
This study was conducted in two main phases. Phase one includes developing the datasheet for registration of DV in the DVRS. In phase two, the datasheet designed in the previous step was used in a pilot implementation of the DVRS for 12 months to find practical challenges. The preliminary datasheet was first developed using information on similar registry programs and guidelines of the World Health Organization (WHO) and then reviewed by four expert panels. Through a two-round Delphi technique, experts evaluated the instrument using the Content Validity Index (CVI) and Content Validity Ratio (CVR). The consistency of the responses was evaluated by test-retest analysis. Finally, two physicians in two forensic medical clinics registered the victims of physical and/or sexual violence perpetrated by a family member.
Preliminary datasheet consisted of 31 items. In the first round of Delphi, fifteen items had good content validity (I-CVI and CVR) and were kept, and seven items were moved to the next round. Also, in the first round of Delphi, experts suggested adding three items, including history of the violence, custody of the child, and custody of the elderly. All items evaluated in the second round were kept due to good CVR and CVI scores. As a result of Test-retest correlation coefficients for self-reprted items, two items including perpetrator's alcohol and drug use status were excluded (r(30) = +.43, and +.38, p< .01, two-tailed, respectively). Finally, 24 items were included in the datasheet including 15 items for individuals' characteristics (victims' characteristics and perpetrators' characteristics), eight items for incidents' characteristics, and one item for past history of violence experience. A total of 369 cases were registered from September 23, 2019, to July 21, 2020. The majority of the reported cases were female (82%) and were 19-40 years old. No physical and/or sexual violence was reported from rural areas, which calls upon researchers to explore how services for detecting and treating the victims can be made accessible to these areas.
DVRS can show trends in DV by age, sex, the context of the violence, and incidence characteristics at every point in time. This is particularly valuable in planning and prioritizing research areas and interventions for DV prevention. Additionally, DVRS can be linked to other disease registry programs which can contribute to continuity and coordination of care, and major research in the future. Although a DVRS can be a promising initiative in identifying the areas in need of urgent interventions, there is no guarantee for its proper implementation due to limited resources and other challenges.
家庭暴力（DV）是一个普遍存在的问题，也是一个重要的公共卫生优先事项。建立家庭暴力登记系统（DVRS）可以帮助系统地整合来自多个来源的数据，并提供有关伤害范围和严重程度的有效和可靠信息。本研究的主要目的是开发、验证和试点测试一个用于在医疗机构登记家庭暴力受害者的最低数据表。
本研究分为两个主要阶段进行。第一阶段包括为 DVRS 中的家庭暴力登记制定数据表。在第二阶段，上一步设计的数据表用于 DVRS 的试点实施 12 个月，以发现实际挑战。初步数据表是使用类似登记计划和世界卫生组织（WHO）的指南中的信息开发的，然后由四个专家小组进行审查。通过两轮德尔菲技术，专家使用内容有效性指数（CVI）和内容有效性比（CVR）评估工具。通过测试 - 重测分析评估了响应的一致性。最后，两名医生在两家法医诊所登记了家庭成员实施的身体和/或性暴力受害者。
初步数据表包含 31 项。在第一轮德尔菲法中，十五项具有良好的内容有效性（I-CVI 和 CVR）并保留，七项进入下一轮。此外，在第一轮德尔菲法中，专家建议增加三项，包括暴力史、子女监护权和老年人监护权。由于第二轮的所有项目的 CVR 和 CVI 得分均较高，因此第二轮的所有项目都被保留。由于自我报告项目的测试 - 重测相关系数，包括犯罪者的酒精和药物使用状况的两项被排除在外（r（30）= +.43 和 +.38，p<.01，双侧，分别）。最后，数据表中包含 24 项，包括 15 项个人特征（受害者特征和犯罪者特征）、8 项事件特征和 1 项过去暴力经历。从 2019 年 9 月 23 日至 2020 年 7 月 21 日，共登记了 369 例。报告的大多数病例为女性（82%），年龄在 19-40 岁之间。农村地区没有报告任何身体和/或性暴力，这要求研究人员探索如何使这些地区的检测和治疗受害者的服务能够普及。
DVRS 可以按年龄、性别、暴力背景和每次发生的事件特征显示 DV 的趋势。这对于规划和确定 DV 预防的优先研究领域特别有价值。此外，DVRS 可以与其他疾病登记计划相关联，这有助于提供连续性和协调性护理，并且是未来的主要研究方向。尽管 DVRS 可以成为识别需要紧急干预的领域的一个有前途的举措，但由于资源有限和其他挑战，其实施并不能得到保证。
