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综合初级保健中的关系健康和亲密伴侣暴力:不同风险水平的个体特征和关系支持偏好。

Relationship Health and Intimate Partner Violence in Integrated Primary Care: Individual Characteristics and Preferences for Relationship Support across Risk Levels.

机构信息

Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, NY 14424, USA.

Department of Psychiatry, University of Rochester Medical Center, Rochester, NY 14642, USA.

出版信息

Int J Environ Res Public Health. 2022 Oct 27;19(21):13984. doi: 10.3390/ijerph192113984.

Abstract

This study explores differences in characteristics and relationship treatment preferences across different levels of intimate partner violence (IPV) among Veterans Affairs (VA) primary care patients. In Fall 2019, we sent a mail-in survey assessing relationship healthcare needs to N = 299 Veterans randomly sampled from 20 northeastern VA primary care clinics (oversampling female and younger Veterans). We compared those reporting past year use or experience of physical/sexual aggression, threats/coercion, or injury (Severe IPV; 21%), to those only reporting yelling and screaming (Verbal Conflict; 51%), and denying any IPV (No IPV; 28%). Participants across groups desired 2-6 sessions of face-to-face support for couples' health and communication. No IPV participants were older and had preferred treatment in primary care. The Verbal Conflict and Severe IPV groups were both flagged by IPV screens and had similar interest in couple treatment and relationship evaluation. The Severe IPV group had higher rates of harms (e.g., depression, alcohol use disorder, relationship dissatisfaction, fear of partner) and higher interest in addressing safety outside of VA. Exploratory analyses suggested differences based on use vs. experience of Severe IPV. Findings highlight ways integrated primary care teams can differentiate services to address dissatisfaction and conflict while facilitating referrals for Severe IPV.

摘要

本研究探讨了退伍军人事务部(VA)初级保健患者中不同程度亲密伴侣暴力(IPV)的特征和关系处理偏好的差异。在 2019 年秋季,我们向从 20 家东北 VA 初级保健诊所随机抽取的 N = 299 名退伍军人发送了一份邮件调查,评估他们的关系医疗保健需求(对女性和年轻退伍军人进行了超额抽样)。我们将那些报告过去一年有身体/性攻击、威胁/胁迫或受伤经历(严重 IPV;21%)的人与那些只报告大喊大叫(言语冲突;51%)和否认任何 IPV(无 IPV;28%)的人进行了比较。各组参与者都希望进行 2-6 次面对面的夫妻健康和沟通支持。无 IPV 参与者年龄较大,更喜欢在初级保健中接受治疗。言语冲突和严重 IPV 组都通过 IPV 筛查标记,并对夫妻治疗和关系评估有类似的兴趣。严重 IPV 组的伤害率(如抑郁、酒精使用障碍、关系不满、对伴侣的恐惧)更高,对在 VA 之外解决安全问题的兴趣更高。探索性分析根据严重 IPV 的使用和经历表明存在差异。研究结果强调了综合初级保健团队可以区分服务以解决不满和冲突,同时促进严重 IPV 的转介的方式。

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