Skauge Anja Duun, Aakvaag Helene Flood, Strøm Ida Frugård, Nissen Alexander, Seifert Louisa Cheng, Överlien Carolina, Dale Maria Teresa Grønning
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
Department of Psychology, University of Oslo, Oslo, Norway.
BMJ Open. 2025 Sep 22;15(9):e101434. doi: 10.1136/bmjopen-2025-101434.
Despite the important role of healthcare services in trauma recovery, many survivors of violence do not seek help. This study aims to examine rates of healthcare utilisation, including differences for physical violence versus rape, gender and physical injury (vs no injury) and obstacles to seeking care within 6 months following incidents of physical violence and rape.
The participants were randomly chosen from the National Population Registry in Norway and invited to participate in a telephone survey on violence exposure and health between June 2021 and June 2022 (N=4299, 49% women).
The sample included 1768 violence-exposed individuals. Of the women (n=749), 82.1% had experienced physical violence and 40.3% had experienced forcible rape. Of the men, most had experienced physical violence (98.6%) and a small percentage had experienced rape (3.5%).
Logistic regression models were used to investigate whether healthcare seeking differed by gender, type of violence (rape vs physical violence) and severity (physical injury). Barriers to accessing healthcare were also investigated using descriptive statistics and content analysis.
Healthcare seeking rates were low after rape (16.9%) and physical violence (24.2%), with somewhat higher rates among individuals experiencing both types of violence (39.9%). There were no statistically significant differences in the odds of healthcare utilisation between the three types of violence exposures when we controlled for gender, physical injury, violence characteristics and sociodemographic factors. Men were more likely than women to have sought healthcare (adjusted OR (aOR): 1.37, 95% CI: 1.02 to 1.85, p=0.042). Physical injury was strongly associated with greater healthcare utilisation (aOR: 6.39, 95% CI: 4.85 to 8.41, p<0.001). Barriers to healthcare seeking included perceptions of violence severity and context, as well as shame and fear of consequences.
Few victims seek healthcare shortly after experiencing rape or physical violence. Quantitative and qualitative findings indicate that many seek healthcare exclusively for severe physical injury. These results emphasise the need to improve health services' outreach to victims of violence, who are at heightened risk of mental health issues and chronic illnesses.
尽管医疗服务在创伤恢复中发挥着重要作用，但许多暴力幸存者并未寻求帮助。本研究旨在调查医疗服务的利用率，包括身体暴力与强奸之间的差异、性别差异以及身体受伤（与未受伤相比）情况，以及在身体暴力和强奸事件发生后的6个月内寻求治疗的障碍。
参与者从挪威国家人口登记处随机选取，并被邀请参加2021年6月至2022年6月期间关于暴力暴露与健康的电话调查（N = 4299，49%为女性）。
样本包括1768名有暴力暴露经历的个体。在女性（n = 749）中，82.1%经历过身体暴力，40.3%经历过强迫性强奸。在男性中，大多数经历过身体暴力（98.6%），一小部分经历过强奸（3.5%）。
使用逻辑回归模型来调查寻求医疗服务的行为是否因性别、暴力类型（强奸与身体暴力）和严重程度（身体受伤）而有所不同。还使用描述性统计和内容分析来调查获得医疗服务的障碍。
强奸（16.9%）和身体暴力（24.2%）后寻求医疗服务的比例较低，同时经历这两种暴力的个体比例略高（39.9%）。当我们控制性别、身体受伤情况、暴力特征和社会人口学因素时，三种暴力暴露类型之间在医疗服务利用率的几率上没有统计学上的显著差异。男性比女性更有可能寻求医疗服务（调整后的比值比（aOR）：1.37，95%置信区间：1.02至1.85，p = 0.042）。身体受伤与更高的医疗服务利用率密切相关（aOR：6.39，95%置信区间：4.85至8.41，p < 0.001）。寻求医疗服务的障碍包括对暴力严重程度和背景的认知，以及羞耻感和对后果的恐惧。
很少有受害者在经历强奸或身体暴力后不久就寻求医疗服务。定量和定性研究结果表明，许多人仅因严重身体受伤而寻求医疗服务。这些结果强调需要改善卫生服务对暴力受害者的宣传，他们面临心理健康问题和慢性病的风险更高。
