Tellez M L, Mackersie R C
Department of Surgery, University of California, San Francisco 94110, USA.
J Trauma. 1996 Apr;40(4):602-6. doi: 10.1097/00005373-199604000-00014.
Violence has become a primary focus for the national agenda and a growing public health concern in the medical community. Although prevention is a major component of public health policy, it is unclear what contribution trauma surgeons and trauma centers are making toward violence prevention.
The purpose of this study was to assess the extent of violence prevention activity at trauma centers, the involvement and attitudes of trauma surgeons toward violence prevention, and the perceived need for a formal violence prevention curriculum.
Self-report postal surveys were sent to trauma directors and associate directors at 430 Level I and Level II trauma centers throughout the United States. A descriptive analysis was performed using the 230 (53%) returns.
55% of Centers reported an active violence prevention program with surgeons participating in these existing programs 47% of the time. Overall, only 26% of surgeons reported being active in violence prevention activities, although 71% thought that violence prevention should be an integral part of trauma center activity. Trauma surgeon involvement in violence prevention and the presence of an active institutional program was demonstrated significantly (p <0.001, chi2). Lack of available time and "not knowing where to start" were cited as the most common reasons for lack of involvement in violence prevention activity.
There is strong support among trauma surgeons for violence prevention programs and for the integration of these programs into the trauma center. A relatively small number of surgeons actually are engaged in violence prevention activity, but most (69%) are willing to become personally involved. The data suggest that established violence prevention programs facilitate involvement of trauma surgeons in violence prevention activity. The discrepancy between actual involvement in, and general support for, violence prevention efforts may be explained by a lack of established roles and previous experience for surgeons and by limited guidance outside of existing programs.
暴力已成为国家议程的主要焦点，并且在医学界日益引起公共卫生关注。尽管预防是公共卫生政策的主要组成部分，但尚不清楚创伤外科医生和创伤中心对预防暴力做出了哪些贡献。
本研究的目的是评估创伤中心预防暴力活动的程度、创伤外科医生对预防暴力的参与情况和态度，以及对正式预防暴力课程的感知需求。
向美国430个一级和二级创伤中心的创伤主任和副主任发送了自填式邮政调查问卷。对230份（53%）回复进行了描述性分析。
55%的中心报告有积极的预防暴力项目，外科医生参与这些现有项目的时间占47%。总体而言，只有26%的外科医生报告积极参与预防暴力活动，尽管71%的人认为预防暴力应成为创伤中心活动的一个组成部分。创伤外科医生参与预防暴力以及存在积极的机构项目之间存在显著关联（p<0.001，卡方检验）。缺乏可用时间和“不知道从哪里开始”被认为是未参与预防暴力活动的最常见原因。
创伤外科医生强烈支持预防暴力项目，并支持将这些项目纳入创伤中心。实际参与预防暴力活动的外科医生相对较少，但大多数（69%）愿意亲自参与。数据表明，既定的预防暴力项目有助于创伤外科医生参与预防暴力活动。实际参与和对预防暴力努力的普遍支持之间的差异可能是由于外科医生缺乏既定角色和以往经验，以及现有项目之外的指导有限。
