Cullinane P M, Alpert E J, Freund K M
Section of General Internal Medicine, Boston University Medical Center, Massachusetts, USA.
Acad Med. 1997 Jan;72(1):48-50.
To assess first-year students' knowledge of, attitudes toward, and personal histories of family violence.
An anonymous, self-administered, 70-item questionnaire was developed and distributed in the first six months of medical school to 390 first-year students at three New England medical schools in 1991-92. The students were tested on knowledge and asked questions about their personal histories. Attitude questions were scored on a five-point Likert scale. Attitude scales were developed by dividing questions into three content groups (education about family violence, the physician as advocate, acceptability of violent behaviors) and removing items for which inter-item coefficients with all other items were less than .20. Two-tailed t-tests were performed on continuous variables and chi-square tests on categorical variables. Ninety-five percent Cls were calculated for point estimates.
In all, 370 students (95%) responded. Of these, 139 (38%) reported personal histories of abuse. The mean knowledge score was 11.3 (of 16 questions). One-third of the students answered more than 75% of these questions correctly; 12% answered less than half of the questions correctly. The women felt more strongly than the men about the need for violence education (p < .001). The students who reported histories of abuse more strongly favored education (p < .05) and advocacy roles (p < .001) for physicians. In addition, the students who had histories of family violence were more likely to report histories of suicidal thoughts (p < .0001).
The students lacked knowledge but felt a need to learn more about family violence. Family violence curricula should be better integrated into medical education. These curricula should be sensitive to students' attitudes, given the reported high prevalence of personal histories of family violence among students.
评估一年级医学生对家庭暴力的了解、态度及个人经历。
1991 - 1992年，在医学院校的前六个月，针对新英格兰三所医学院的390名一年级学生，设计并发放了一份70项的匿名自填问卷。对学生进行知识测试，并询问他们的个人经历。态度问题采用五点李克特量表计分。通过将问题分为三个内容组（家庭暴力教育、医生作为倡导者、暴力行为的可接受性）并删除与所有其他项目的项目间系数小于0.20的项目，来制定态度量表。对连续变量进行双尾t检验，对分类变量进行卡方检验。计算点估计值的95%置信区间。
共有370名学生（95%）做出回应。其中，139名（38%）报告有虐待的个人经历。知识测试的平均得分是11.3分（满分16分）。三分之一的学生正确回答了超过75%的问题；12%的学生正确回答的问题不到一半。女性比男性更强烈地认为需要进行暴力教育（p < 0.001）。报告有虐待经历的学生更强烈地支持医生开展教育（p < 0.05）和倡导工作（p < 0.001）。此外，有家庭暴力史的学生更有可能报告有自杀念头史（p < 0.0001）。
学生缺乏相关知识，但感到有必要更多地了解家庭暴力。家庭暴力课程应更好地融入医学教育。鉴于报告显示学生中家庭暴力个人经历的高发生率，这些课程应考虑学生的态度。
