McCauley J, Kern D E, Kolodner K, Dill L, Schroeder A F, DeChant H K, Ryden J, Bass E B, Derogatis L R
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ann Intern Med. 1995 Nov 15;123(10):737-46. doi: 10.7326/0003-4819-123-10-199511150-00001.
To determine the prevalence of domestic violence among female patients and to identify clinical characteristics that are associated with current domestic violence.
Cross-sectional, self-administered, anonymous survey.
4 community-based, primary care internal medicine practices.
1952 female patients of varied age and marital, educational, and economic status who were seen from February to July 1993.
The survey instrument included previously validated questions on physical and sexual abuse, alcohol abuse, and emotional status and questions on demographic characteristics, physical symptoms, use of street drugs and prescribed medications, and medical and psychiatric history.
108 of the 1952 respondents (5.5%) had experienced domestic violence in the year before presentation. Four hundred eighteen (21.4%) had experienced domestic violence sometime in their adult lives, 429 (22.0%) before age 18 years, and 639 (32.7%) as either an adult or child. Compared with women who had not recently experienced domestic violence, currently abused patients were more likely to be younger than 35 years of age (prevalence ratio [PR], 4.1 [95% CI, 2.8 to 6.0]); were more likely to be single, separated, or divorced (PR, 2.5 [CI, 1.7 to 3.6]); were more likely to be receiving medical assistance or to have no insurance (PR, 4.3 [CI, 2.8 to 6.6]); had more physical symptoms (mean, 7.3 +/- 0.38 compared with 4.6 +/- 0.08; P < 0.001); had higher scores on instruments for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P < 0.001); were more likely to have a partner abusing drugs or alcohol (PR, 6.3 [CI, 4.4 to 9.2]); were more likely to be abusing drugs (PR, 4.4 [CI, 1.9 to 10.4]) or alcohol (PR, 3.1 [CI, 1.5 to 6.5]); and were more likely to have attempted suicide (PR, 4.3 [CI, 2.8 to 6.5]). They visited the emergency department more frequently (PR, 1.7 [CI, 1.2 to 2.5]) but did not have more hospitalizations for psychiatric disorders. In a logistic regression model into which 9 risk factors were entered, the likelihood of current abuse increased with the number of risk factors, from 1.2% when 0 to 1 risk factors were present to 70.4% when 6 to 7 risk factors were present.
In a large, diverse, community-based population of primary care patients, 1 of every 20 women had experienced domestic violence in the previous year; 1 of every 5 had experienced violence in their adult life; and 1 of every 3 had experienced violence as either a child or an adult. Current domestic violence is associated with single or separated status, socioeconomic status, substance abuse, specific psychological symptoms, specific physical symptoms, and the total number of physical symptoms.
确定女性患者中家庭暴力的患病率，并识别与当前家庭暴力相关的临床特征。
横断面、自行填写、匿名调查。
4个社区基层医疗内科诊所。
1952名年龄、婚姻状况、教育程度和经济状况各异的女性患者，于1993年2月至7月就诊。
调查问卷包括先前经验证的关于身体和性虐待、酒精滥用及情绪状况的问题，以及关于人口统计学特征、身体症状、使用街头毒品和处方药情况、医疗和精神病史的问题。
1952名受访者中有108人（5.5%）在就诊前一年遭受过家庭暴力。418人（21.4%）在成年后的某个时候遭受过家庭暴力，429人（22.0%）在18岁之前遭受过，639人（32.7%）在儿童或成年时期遭受过。与近期未遭受家庭暴力的女性相比，当前受虐患者更可能年龄小于35岁（患病率比[PR]，4.1[95%CI，2.8至6.0]）；更可能单身、分居或离婚（PR，2.5[CI，1.7至3.6]）；更可能接受医疗救助或没有保险（PR，4.3[CI，2.8至6.6]）；有更多身体症状（平均，7.3±0.38，而未受虐者为4.6±0.08；P<0.001）；在抑郁、焦虑、躯体化和人际敏感（自卑）量表上得分更高（P<0.001）；更可能有伴侣滥用毒品或酒精（PR，6.3[CI，4.4至9.2]）；更可能滥用毒品（PR，4.4[CI，1.9至10.4]）或酒精（PR，3.1[CI,1.5至6.5]）；更可能曾尝试自杀（PR，4.3[CI，2.8至6.5]）。她们更频繁地前往急诊科就诊（PR，1.7[CI，1.2至2.5]），但因精神疾病住院的次数并未更多。在纳入9个风险因素的逻辑回归模型中，当前受虐的可能性随风险因素数量的增加而增加，从存在0至1个风险因素时的1.2%增至存在6至7个风险因素时的70.4%。
在一个大型、多样化的社区基层医疗患者群体中，每20名女性中有1人在过去一年遭受过家庭暴力；每5名女性中有1人在成年后遭受过暴力；每3名女性中有1人在儿童或成年时期遭受过暴力。当前的家庭暴力与单身或分居状态、社会经济状况、物质滥用、特定心理症状、特定身体症状以及身体症状总数有关。
