Wolfe D A, Korsch B
Centre for Research on Violence Against Women and Children, University of Western Ontario, London, Canada.
Pediatrics. 1994 Oct;94(4 Pt 2):594-9.
The traditional role of the pediatrician, which consisted primarily of making diagnoses and prescribing treatments for specific disease entities in children, has expanded dramatically to include psychosocial aspects of health care as well as problems that are primarily psychological, emotional, or social in nature and that extend in various ways to the family and to the child's environment. One of these problems has been identified as the manner in which witnessing domestic violence, a significant and relatively commonplace event for many children today, affects child development and behavior. This paper reviews our existing knowledge of such events and explores how exposure to conflict and violence plays a major role in how children learn to relate to others, how they develop their self-concept and self-control, and how they interact with dating and marital partners in the future. We conclude with a discussion of the role of the pediatrician in interviewing children and other family members and in identifying appropriate avenues for prevention and treatment. Major recommendations derived from this paper include: decreasing the attitudinal barriers to exploring this issue; increasing sensitivity to clinical features and behavioral symptoms of children who witness domestic violence; and increasing knowledge of available resources for treatment and prevention.
儿科医生的传统角色主要是对儿童的特定疾病实体进行诊断和开处治疗方案，如今已大幅扩展，涵盖了医疗保健的心理社会方面，以及本质上主要是心理、情感或社会层面且以各种方式延伸至家庭和儿童所处环境的问题。其中一个问题已被确定为目睹家庭暴力这一现象（如今对许多儿童来说是重大且相对常见的事件）影响儿童发育和行为的方式。本文回顾了我们目前对此类事件的认识，并探讨了接触冲突和暴力如何在儿童学习与他人建立关系、形成自我概念和自我控制能力以及未来与约会和婚姻伴侣互动等方面发挥主要作用。我们最后讨论了儿科医生在询问儿童及其他家庭成员以及确定预防和治疗的合适途径方面的作用。本文得出的主要建议包括：减少探索这一问题的态度障碍；提高对目睹家庭暴力儿童的临床特征和行为症状的敏感度；以及增加对可用治疗和预防资源的了解。
