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筛查亲密伴侣暴力以及对老年人或弱势成年人的照料者虐待:美国预防服务工作组建议声明

Screening for Intimate Partner Violence and Caregiver Abuse of Older or Vulnerable Adults: US Preventive Services Task Force Recommendation Statement.

作者信息

Silverstein Michael, Wong John B, Davis Esa M, Chelmow David, Coker Tumaini Rucker, Fernandez Alicia, Gibson Ericka, Jaén Carlos Roberto, Krousel-Wood Marie, Lee Sei, Nicholson Wanda K, Rao Goutham, Ruiz John M, Stevermer James, Tsevat Joel, Underwood Sandra Millon, Wiehe Sarah

机构信息

Brown University, Providence, Rhode Island.

Tufts University School of Medicine, Boston, Massachusetts.

出版信息

JAMA. 2025 Jul 22;334(4):329-338. doi: 10.1001/jama.2025.9009.

Abstract

IMPORTANCE

Intimate partner violence (IPV) affects millions of US residents across the lifespan and is often unrecognized. Abuse of older or vulnerable adults by a caregiver or someone else they may trust is common and can result in significant injury, death, and long-term adverse health consequences.

OBJECTIVE

The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for IPV, abuse of older adults, and abuse of vulnerable adults.

POPULATION

The recommendation on screening for IPV applies to adolescents and adults who are pregnant or postpartum, and women of reproductive age. The recommendation on screening in older and vulnerable adults applies to persons without recognized signs and symptoms of abuse or neglect.

EVIDENCE ASSESSMENT

The USPSTF concludes that screening for IPV in women of reproductive age, including those who are pregnant and postpartum, and providing or referring those who screen positive to multicomponent interventions has a moderate net benefit. The USPSTF concludes that the benefits and harms of screening for caregiver abuse and neglect in older or vulnerable adults are uncertain and that the balance of benefits and harms cannot be determined.

RECOMMENDATION

The USPSTF recommends that clinicians screen for IPV in women of reproductive age, including those who are pregnant and postpartum. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for caregiver abuse and neglect in older or vulnerable adults. (I statement).

摘要

重要性

亲密伴侣暴力(IPV)影响着数百万美国各年龄段居民,且往往未被识别。照顾者或其他受信任之人对老年人或弱势成年人的虐待很常见,可能导致严重伤害、死亡以及长期不良健康后果。

目的

美国预防服务工作组(USPSTF)委托进行了一项系统评价,以评估筛查IPV、虐待老年人以及虐待弱势成年人的益处和危害。

人群

关于筛查IPV的建议适用于怀孕或产后的青少年和成年人以及育龄妇女。关于筛查老年人和弱势成年人的建议适用于无虐待或忽视的公认体征和症状的人群。

证据评估

USPSTF得出结论,对育龄妇女(包括怀孕和产后妇女)筛查IPV,并为筛查呈阳性者提供或转介至多成分干预措施具有中等净效益。USPSTF得出结论,筛查老年人或弱势成年人中照顾者虐待和忽视的益处和危害尚不确定,且无法确定其利弊平衡。

建议

USPSTF建议临床医生对育龄妇女(包括怀孕和产后妇女)筛查IPV。(B级推荐)USPSTF得出结论,目前证据不足以评估筛查老年人或弱势成年人中照顾者虐待和忽视的利弊平衡。(I声明)

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