Dheensa Sandi, McLindon Elizabeth, Spencer Chelsea, Pereira Stephanie, Shrestha Satya, Emsley Elizabeth, Gregory Alison
Domestic Violence and Abuse Health Research Group, Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK.
The Royal Women's Hospital, University of Melbourne, Melbourne, VIC, Australia.
Trauma Violence Abuse. 2023 Jul;24(3):1282-1299. doi: 10.1177/15248380211061771. Epub 2022 Jan 3.
Globally, healthcare professionals (HCPs) are increasingly asked to identify and respond to domestic violence and abuse (DVA) among patients. However, their own experiences of DVA have been largely ignored. To determine the prevalence of current and lifetime DVA victimisation among HCPs globally, and identify risk markers, consequences and support-seeking for DVA.Method: PubMed, EMBASE, PsycINFO, CINAHL ASSIA and ProQuest were searched. Studies about HCPs' personal experience of any type of DVA from any health service/country were included. Meta-analysis and narrative synthesis were adopted. Fifty-one reports were included. Pooled lifetime prevalence was 31.3% (95% CI [24.7%, 38.7%] < .001)) and past-year prevalence was 10.4% (95% CI [5.8%, 17.9%] <.001). Pooled lifetime prevalence significantly differed (Qb=6.96, < .01) between men (14.8%) and women (41.8%), and between HCPs in low-middle income (64.0%) and high-income countries (20.7%) (Qb = 31.41, <.001). Risk markers were similar to those in the general population, but aspects of the HCP role posed additional and unique risks/vulnerabilities. Direct and indirect consequences of DVA meant HCP-survivors were less able to work to their best ability. While HCP-survivors were more likely than other HCPs to identify and respond to DVA among patients, doing so could be distressing. HCP-survivors faced unique barriers to seeking support. Being unable to access support - which is crucial for leaving or ending relationships with abusive people - leaves HCP-survivors entrapped. Specialised DVA interventions for HCPs are urgently needed, with adaptations for different groups and country settings. Future research should focus on developing interventions with HCP-survivors.
在全球范围内，医疗保健专业人员（HCPs）越来越多地被要求识别并应对患者中的家庭暴力和虐待（DVA）问题。然而，他们自身遭受DVA的经历在很大程度上被忽视了。为了确定全球范围内HCPs中当前和终生遭受DVA侵害的患病率，并识别DVA的风险指标、后果及寻求支持的情况。方法：检索了PubMed、EMBASE、PsycINFO、CINAHL ASSIA和ProQuest。纳入了关于来自任何卫生服务机构/国家的HCPs任何类型DVA个人经历的研究。采用了荟萃分析和叙述性综合分析。共纳入51份报告。终生合并患病率为31.3%（95%可信区间[24.7%，38.7%]，P<0.001），过去一年患病率为10.4%（95%可信区间[5.8%，17.9%]，P<0.001）。男性（14.8%）和女性（41.8%）的终生合并患病率存在显著差异（Qb=6.96，P<0.01），中低收入国家（64.0%）和高收入国家（20.7%）的HCPs之间也存在显著差异（Qb = 31.41，P<0.001）。风险指标与普通人群相似，但HCP角色的某些方面带来了额外的独特风险/脆弱性。DVA的直接和间接后果意味着HCP幸存者无法充分发挥其最佳工作能力。虽然HCP幸存者比其他HCPs更有可能识别并应对患者中的DVA问题，但这样做可能会令人痛苦。HCP幸存者在寻求支持方面面临独特障碍。无法获得支持——这对于离开或结束与施虐者的关系至关重要——使HCP幸存者陷入困境。迫切需要针对HCPs的专门DVA干预措施，并针对不同群体和国家背景进行调整。未来的研究应侧重于与HCP幸存者共同开发干预措施。
