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安大略省医学专业人员转介的儿童福利机构对亲密伴侣暴力暴露情况的调查:一个特别脆弱的群体?

Child Welfare Investigations of Exposure to Intimate Partner Violence Referred by Medical Professionals in Ontario: A Uniquely Vulnerable Population?

作者信息

Joh-Carnella Nicolette, Livingston Eliza, Stoddart Jill, Fallon Barbara

机构信息

Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada.

出版信息

Healthcare (Basel). 2023 Sep 21;11(18):2599. doi: 10.3390/healthcare11182599.

Abstract

Victims of intimate partner violence (IPV) and their children may be at an increased risk for negative health outcomes and may present to healthcare settings. The objective of the current study is to examine the profile of medical-referred child welfare investigations of exposure to IPV in Ontario, Canada. Data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 were used. We compared medical-referred investigations with all other investigations of exposure to IPV. Descriptive and bivariate analyses as well as a logistic regression predicting transfers to ongoing services were conducted. Six percent of investigations of exposure to IPV conducted in Ontario in 2018 were referred by a medical source. Compared to other investigations of exposure to IPV, these investigations were more likely to involve younger children ( = 0.005), caregivers with mental health issues ( < 0.001) and few social supports ( = 0.004), and households noted to be overcrowded ( = 0.001). After controlling for clinical case characteristics, investigations of exposure to IPV referred by healthcare sources were 3.452 times as likely to be kept open for ongoing child welfare services compared to those referred by other sources (95% CI [2.024, 5.886]; < 0.001). Children and their families who are identified in healthcare settings for concerns of exposure to IPV tend to receive extended child welfare intervention compared to those identified elsewhere. There is a clear difference in service provision in healthcare-originating investigations of exposure to IPV versus investigations originating from other sources. Further research into the services provided to victims of IPV and their children is needed.

摘要

亲密伴侣暴力(IPV)的受害者及其子女可能面临负面健康后果的风险增加,并且可能会前往医疗机构就诊。本研究的目的是调查加拿大安大略省因医疗转诊而进行的儿童福利机构对IPV暴露情况的调查概况。使用了2018年安大略省报告的虐待和忽视儿童事件发生率研究的数据。我们将因医疗转诊进行的调查与所有其他IPV暴露情况的调查进行了比较。进行了描述性和双变量分析以及预测向持续服务转诊情况的逻辑回归分析。2018年在安大略省进行的IPV暴露情况调查中有6%是由医疗来源转诊的。与其他IPV暴露情况的调查相比,这些调查更有可能涉及年幼的儿童(P = 0.005)、有心理健康问题的照顾者(P < 0.001)、社会支持较少(P = 0.004)以及被指出过度拥挤的家庭(P = 0.001)。在控制了临床病例特征后,与其他来源转诊的调查相比,医疗来源转诊的IPV暴露情况调查被保留用于持续儿童福利服务的可能性高出3.452倍(95%置信区间[2.024, 5.886];P < 0.001)。与在其他地方被确认的儿童及其家庭相比,在医疗机构中因担心暴露于IPV而被确认的儿童及其家庭往往会接受更长期的儿童福利干预。在因医疗原因发起的IPV暴露情况调查与其他来源发起的调查之间,服务提供存在明显差异。需要对向IPV受害者及其子女提供的服务进行进一步研究。

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