Redeker N S, Smeltzer S C, Kirkpatrick J, Parchment S
College of Nursing, Rutgers-The State University of New Jersey, Newark, USA.
Am J Crit Care. 1995 Sep;4(5):370-8.
Repeated injury, or recidivism, because of intentional or unintentional injury is a growing chronic health problem among urban adolescents and young adults in the United States.
To describe demographic, social, environmental, psychological, and developmental antecedents and risk-taking behaviors, and to examine their relationships to type of trauma and rate of trauma recidivism in adolescent and young adults in an urban trauma center.
One hundred adolescent and young adult trauma victims in an urban trauma center were interviewed, using the Adolescent Risk-Taking Instrument, the Brief Anger/Aggression Questionnaire, and the Trauma Risk Factor Interview Schedule. Bivariate correlation, multiple regression, and discriminant function analysis were used to examine the data.
Of the sample, 89% experienced trauma related to interpersonal violence, including firearm injuries, stab wounds, and blunt trauma. Male gender, unemployment, past arrest, lower levels of spirituality, and higher levels of anger/aggression and thrill-seeking accounted for 25% of the variance in the number of risk-taking behaviors. Factors such as male gender, past arrest, unemployment, having been a crime victim in the past, lower autonomy, use of weapons, fighting, and no psychological counseling distinguished subjects with firearm-related injuries from subjects with other injury sources. Use of alcohol on weekdays, past arrest, and higher education levels were associated with trauma recidivism, explaining 14% of the variance.
Social/environmental and psychological/developmental variables, as well as risk-taking behaviors, are important correlates of trauma and recidivism. These findings suggest the importance of advocacy for social policies conductive to reducing the risks of violence and trauma and risk-reduction interventions as components of posttrauma care.
在美国城市青少年和青年中,因有意或无意伤害导致的重复性损伤或累犯是一个日益严重的慢性健康问题。
描述人口统计学、社会、环境、心理和发育方面的先兆因素及冒险行为,并研究它们与城市创伤中心青少年和青年创伤类型及创伤累犯率之间的关系。
采用青少年冒险行为量表、简短愤怒/攻击问卷和创伤风险因素访谈时间表,对城市创伤中心的100名青少年和青年创伤受害者进行访谈。使用双变量相关性分析、多元回归分析和判别函数分析来检验数据。
在样本中,89%经历了与人际暴力相关的创伤,包括火器伤、刺伤和钝器伤。男性、失业、过去曾被捕、精神性较低、愤怒/攻击性较高以及寻求刺激程度较高,占冒险行为数量方差的25%。男性、过去曾被捕、失业、过去曾是犯罪受害者、自主性较低、使用武器、打架以及未接受心理咨询等因素,将火器相关损伤的受试者与其他损伤来源的受试者区分开来。平日饮酒、过去曾被捕和较高的教育水平与创伤累犯相关,解释了14%的方差。
社会/环境和心理/发育变量以及冒险行为是创伤和累犯的重要相关因素。这些发现表明,倡导有利于降低暴力和创伤风险的社会政策以及将降低风险干预措施作为创伤后护理的组成部分具有重要意义。