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围产期亲密伴侣暴力筛查中与残疾相关的差异:一项基于人群的研究。

Disability-Related Disparities in Screening for Intimate Partner Violence During the Perinatal Period: A Population-Based Study.

作者信息

Laughon Kathryn, Hughes Rosemary B, Lyons Genevieve, Roarty Kana, Alhusen Jeanne

机构信息

University of Virginia School of Nursing, Charlottesville, Virginia.

University of Montana Rural Institute for Inclusive Communities, Missoula, Montana.

出版信息

Womens Health Issues. 2025 Mar-Apr;35(2):97-104. doi: 10.1016/j.whi.2024.12.001. Epub 2025 Jan 9.

DOI:10.1016/j.whi.2024.12.001
PMID:39788839
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11911073/
Abstract

BACKGROUND

Persons with disabilities are at higher risk of experiencing intimate partner violence (IPV) during the perinatal period than persons without disabilities. Although screening for IPV during the perinatal period is recommended by many organizations, little is known about screening rates for IPV by disability status.

METHODS

Our objective was to compare rates of IPV screening during the perinatal period among persons with and without disabilities in the United States. A cross-sectional sample of 43,837 respondents provided data on disability, including difficulty in vision, hearing, ambulation, cognition, communication, and self-care. We conducted a secondary analysis of nationally representative data from the 2018-2020 Pregnancy Risk Assessment Monitoring System.

RESULTS

During pregnancy, respondents with disabilities had a lower odds of IPV screening as compared with respondents without disabilities (adjusted odds ratio .83, 95% confidence interval [.70, .99]). Despite similar screening rates in the 12 months before conception and postpartum among respondents with and without disabilities who attended health care visits, those with disabilities were less likely to receive pregnancy-related care during pregnancy (p < .0001) and in the postpartum period (p < .0001) and thus missed opportunities to be screened.

CONCLUSION

Our findings demonstrate a need for health care providers to collaborate with policy makers, disability advocates, and researchers to reduce the disparities people with disabilities face in accessing health care, including screening for IPV during the perinatal period. Such efforts are essential for maximizing the health and safety of pregnant persons and new parents with disabilities and their children during the perinatal period.

摘要

背景

与非残疾人士相比,残疾人士在围产期遭受亲密伴侣暴力(IPV)的风险更高。尽管许多组织都建议在围产期筛查IPV,但关于按残疾状况划分的IPV筛查率却知之甚少。

方法

我们的目标是比较美国残疾和非残疾人士在围产期的IPV筛查率。一个由43837名受访者组成的横断面样本提供了有关残疾的信息,包括视力、听力、行走、认知、沟通和自我护理方面的困难。我们对2018 - 2020年妊娠风险评估监测系统的全国代表性数据进行了二次分析。

结果

在孕期,与非残疾受访者相比,残疾受访者接受IPV筛查的几率较低(调整后的优势比为0.83,95%置信区间[0.70, 0.99])。尽管在怀孕前12个月以及产后,有和没有残疾且就诊的受访者筛查率相似,但残疾受访者在孕期(p < 0.0001)和产后阶段(p < 0.0001)接受与妊娠相关护理的可能性较小,因此错过了被筛查的机会。

结论

我们的研究结果表明,医疗保健提供者需要与政策制定者、残疾权益倡导者和研究人员合作,以减少残疾人士在获得医疗保健方面面临的差距,包括围产期IPV筛查。这些努力对于在围产期最大限度地保障残疾孕妇、新父母及其子女的健康和安全至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5732/11911073/790b0b9d307b/nihms-2047566-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5732/11911073/790b0b9d307b/nihms-2047566-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5732/11911073/790b0b9d307b/nihms-2047566-f0001.jpg

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本文引用的文献

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Intimate partner violence: A clinical update.亲密伴侣暴力:临床最新进展。
Nurse Pract. 2023 Sep 1;48(9):40-46. doi: 10.1097/01.NPR.0000000000000088.
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Reproductive Coercion Among Women With Disabilities: An Analysis of Pregnancy Risk Assessment Monitoring Systems Data.残疾女性的生殖胁迫:妊娠风险评估监测系统数据的分析。
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Depressive symptoms during the perinatal period by disability status: Findings from the United States Pregnancy Risk Assessment Monitoring System.围产期残疾状况下的抑郁症状:来自美国妊娠风险评估监测系统的研究结果。
J Adv Nurs. 2023 Jan;79(1):223-233. doi: 10.1111/jan.15482. Epub 2022 Nov 1.
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Obstet Gynecol. 2022 Nov 1;140(5):797-805. doi: 10.1097/AOG.0000000000004950. Epub 2022 Oct 5.
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Have Almost Fifty Years Of Disability Civil Rights Laws Achieved Equitable Care?近五十年的残疾民权法实现公平护理了吗?
Health Aff (Millwood). 2022 Oct;41(10):1371-1378. doi: 10.1377/hlthaff.2022.00413.
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Intimate partner violence during the perinatal period by disability status: Findings from a United States population-based analysis.围产期残疾状况与亲密伴侣暴力:一项基于美国人群的分析结果。
J Adv Nurs. 2023 Apr;79(4):1493-1502. doi: 10.1111/jan.15340. Epub 2022 Jun 30.
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A scoping review of measurement of violence against women and disability.一项针对暴力侵害妇女和残疾问题测量的范围综述。
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"They Didn't Ask." Rural Women With Disabilities and Experiences of Violence Describe Interactions With the Healthcare System.“她们未被询问。”残疾农村妇女与暴力经历讲述与医疗保健系统的互动
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Risk of Adverse Maternal Outcomes in Pregnant Women With Disabilities.残疾孕妇不良母婴结局的风险。
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