创伤中心和急诊科对亲密伴侣暴力的筛查与干预：来自东部创伤外科学会的循证系统评价
Screening and intervention for intimate partner violence at trauma centers and emergency departments: an evidence-based systematic review from the Eastern Association for the Surgery of Trauma.
作者信息
Teichman Amanda L, Bonne Stephanie, Rattan Rishi, Dultz Linda, Qurashi Farheen A, Goldenberg Anna, Polite Nathan, Liveris Anna, Freeman Jennifer J, Colosimo Christina, Chang Erin, Choron Rachel L, Edwards Courtney, Arabian Sandra, Haines Krista L, Joseph D'Andrea, Murphy Patrick B, Schramm Andrew T, Jung Hee Soo, Lawson Emily, Fox Kathleen, Mashbari Hassan Naser A, Smith Randi N
机构信息
Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA.
Trauma and Surgical Critical Care, Hackensack Meridian Hackensack University Medical Center, Hackensack, New Jersey, USA.
出版信息
Trauma Surg Acute Care Open. 2023 Mar 16;8(1):e001041. doi: 10.1136/tsaco-2022-001041. eCollection 2023.
BACKGROUND
Intimate partner violence (IPV) is a serious public health issue with a substantial burden on society. Screening and intervention practices vary widely and there are no standard guidelines. Our objective was to review research on current practices for IPV prevention in emergency departments and trauma centers in the USA and provide evidenced-based recommendations.
METHODS
An evidence-based systematic review of the literature was conducted to address screening and intervention for IPV in adult trauma and emergency department patients. The Grading of Recommendations, Assessment, Development and Evaluations methodology was used to determine the quality of evidence. Studies were included if they addressed our prespecified population, intervention, control, and outcomes questions. Case reports, editorials, and abstracts were excluded from review.
RESULTS
Seven studies met inclusion criteria. All seven were centered around screening for IPV; none addressed interventions when abuse was identified. Screening instruments varied across studies. Although it is unclear if one tool is more accurate than others, significantly more victims were identified when screening protocols were implemented compared with non-standardized approaches to identifying IPV victims.
CONCLUSION
Overall, there were very limited data addressing the topic of IPV screening and intervention in emergency medical settings, and the quality of the evidence was low. With likely low risk and a significant potential benefit, we conditionally recommend implementation of a screening protocol to identify victims of IPV in adults treated in the emergency department and trauma centers. Although the purpose of screening would ultimately be to provide resources for victims, no studies that assessed distinct interventions met our inclusion criteria. Therefore, we cannot make specific recommendations related to IPV interventions.
PROSPERO REGISTRATION NUMBER
CRD42020219517.
背景
亲密伴侣暴力（IPV）是一个严重的公共卫生问题，给社会带来了沉重负担。筛查和干预措施差异很大，且没有标准指南。我们的目标是回顾美国急诊科和创伤中心预防亲密伴侣暴力的现行做法的研究，并提供循证建议。
方法
对文献进行循证系统综述，以探讨成年创伤患者和急诊科患者亲密伴侣暴力的筛查和干预。采用推荐分级、评估、制定与评价方法来确定证据质量。纳入的研究需涉及我们预先设定的人群、干预措施、对照和结局问题。病例报告、社论和摘要被排除在综述之外。
结果
七项研究符合纳入标准。所有七项研究均围绕亲密伴侣暴力的筛查；在识别出虐待行为时，均未涉及干预措施。不同研究的筛查工具各不相同。虽然尚不清楚一种工具是否比其他工具更准确，但与非标准化的亲密伴侣暴力受害者识别方法相比，实施筛查方案时识别出的受害者明显更多。
结论
总体而言，关于急诊医疗环境中亲密伴侣暴力筛查和干预主题的数据非常有限，证据质量较低。鉴于风险可能较低且潜在益处显著，我们有条件地建议实施筛查方案，以识别在急诊科和创伤中心接受治疗的成年亲密伴侣暴力受害者。虽然筛查的最终目的是为受害者提供资源，但没有评估不同干预措施的研究符合我们的纳入标准。因此，我们无法就亲密伴侣暴力干预措施提出具体建议。
国际前瞻性系统评价注册编号
CRD42020219517。
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