Alpert E J
Boston University School of Medicine, Massachusetts, USA.
Ann Intern Med. 1995 Nov 15;123(10):774-81. doi: 10.7326/0003-4819-123-10-199511150-00006.
Domestic violence is endemic in U.S. society and is seen in nearly every venue of medical care. A history of abuse should be considered and routinely queried in all women who present for emergency care, should be suspected in any woman who presents with an injury, and should be routinely screened for in primary care settings. Clinical manifestations, suggested diagnostic strategies, obstacles to leaving the abusive relationship, and the barriers that patients face in obtaining and that physicians face in providing optimal care in situations of domestic violence are discussed. Physicians can play a pivotal role in primary prevention, early intervention, and follow-up care during and after an episode of intimate partner violence. Clinical competence in the treatment and prevention of family violence is an important component of the new agenda for health care, particularly in generalist fields such as general internal medicine.
家庭暴力在美国社会中极为普遍，几乎在医疗护理的各个场所都能见到。对于所有前来接受急诊护理的女性，都应考虑并常规询问其是否有受虐史；对于任何有受伤情况的女性，都应怀疑其遭受过家庭暴力；在初级保健机构中，也应常规筛查家庭暴力情况。本文讨论了家庭暴力的临床表现、建议的诊断策略、离开虐待关系的障碍以及患者在获取帮助时面临的障碍和医生在家庭暴力情况下提供最佳护理时面临的障碍。医生在亲密伴侣暴力事件期间及之后的初级预防、早期干预和后续护理中可发挥关键作用。治疗和预防家庭暴力的临床能力是医疗保健新议程的重要组成部分，尤其是在普通内科等全科领域。
