Reid S A, Glasser M
Department of Internal Medicine, St. Vincent Hospital, Indianapolis, Indiana, USA.
Acad Med. 1997 Jan;72(1):51-3.
Physicians fail to identify the majority of domestic violence victims, even though they are often the first and only individuals to whom a victim may present. The present study was designed to assess primary care physicians' recognition of and attitudes toward domestic violence.
Of the 148 primary care physicians in three midwestern counties, all the women and a random sample of the men were included in the survey, for a total of 83. A seven-page questionnaire was developed that contained items about demographics and practice characteristics, and questions about the following aspects of domestic violence: knowledge, attitudes, importance, and prevalence in practice; attitudes toward responsibility; current practices and protocols used; level of education and domestic violence received; and opinions on how best to distribute information and/or education concerning domestic violence. The questionnaire was mailed in 1994. Follow-up was conducted through phone calls, remailings, and visits to the physicians' offices. Responses were examined using chi-square tests and two-tailed t-tests.
The response rate was 63% (52 of 83); 53% of those responding were family physicians and 47% were general internists; 34% were women. Although all of the physicians agreed that finding and treating domestic violence is important, less than half agreed that domestic violence was a significant problem in their patient populations. Almost 96% of the physicians believed that more should be done to educate physicians about domestic violence, and 94% agreed that domestic violence should be included in a doctor's professional medical training; yet nearly half said they would not participate in a domestic violence forum. Even though 41% noted that they had received some type of formal education about domestic violence, 57% felt that their medical education had inadequately prepared them to deal with domestic violence, and less than 25% reported that they had been trained to diagnose domestic violence. The family physicians and the female physicians had received more education about domestic violence and were more comfortable addressing domestic-violence situations. The older physicians were less comfortable addressing domestic violence and were less likely to agree that education about domestic violence should be a part of medical training.
Interventions by the medical community to increase physician awareness of domestic violence and available treatment resources are necessary, and domestic-violence information should be included in formal medical curricula.
尽管医生常常是家庭暴力受害者最先接触且唯一接触的人，但大多数医生无法识别出这些受害者。本研究旨在评估基层医疗医生对家庭暴力的认知和态度。
在中西部三个县的148名基层医疗医生中，所有女性医生以及男性医生的一个随机样本被纳入调查，共计83人。设计了一份七页的问卷，包含有关人口统计学和执业特征的项目，以及关于家庭暴力以下方面的问题：知识、态度、重要性、在执业中的普遍性；对责任的态度；当前使用的做法和方案；接受的教育程度和家庭暴力情况；以及关于如何最好地传播有关家庭暴力的信息和/或教育的意见。问卷于1994年邮寄。通过电话、再次邮寄以及走访医生办公室进行随访。使用卡方检验和双侧t检验对回复进行分析。
回复率为63%（83人中52人）；回复者中53%是家庭医生，47%是普通内科医生；34%是女性。尽管所有医生都认同发现并治疗家庭暴力很重要，但不到一半的医生认为家庭暴力在他们的患者群体中是一个严重问题。近96%的医生认为应该采取更多措施对医生进行家庭暴力方面的教育，94%的医生同意家庭暴力应纳入医生的专业医学培训；然而近一半的医生表示他们不会参加家庭暴力论坛。尽管41%的医生指出他们接受过某种形式的家庭暴力正规教育，但57%的医生觉得他们的医学教育没有让他们做好应对家庭暴力的充分准备，不到25%的医生报告说他们接受过诊断家庭暴力的培训。家庭医生和女医生接受过更多关于家庭暴力的教育，在处理家庭暴力情况时更得心应手。年长的医生在处理家庭暴力时较不自在，也不太可能认同家庭暴力教育应成为医学培训的一部分。
医疗界采取干预措施以提高医生对家庭暴力及可用治疗资源的认识是必要的，家庭暴力信息应纳入正规医学课程。
