Ernst A A, Nick T G, Weiss S J, Houry D, Mills T
Department of Emergency Medicine, Vanderbilt University, Nashville, TN 37232-4700, USA.
Ann Emerg Med. 1997 Aug;30(2):190-7. doi: 10.1016/s0196-0644(97)70141-0.
To determine the prevalence of domestic violence (DV) for male and female ED patients and to determine the demographics of DV.
The study design was a descriptive written survey of adults. We used the Index of Spouse Abuse (ISA), a previously validated survey tool. The study was set in an inner-city ED with approximately 75,000 patients annually, most of them indigent. Patients 18 years or older who were able to give consent were included. Patients were excluded if they had a language barrier, were a prisoner, or had never had a partner. All patients presenting during 31 randomly selected 4-hour shifts during July 1995 were considered for the study. DV was defined as either physical or nonphysical on the basis of ISA scoring. The prevalence was determined for present (in the preceding year) and past (more than 1 year ago) abuse. Four violence parameters were calculated for patients who had a partner at the time of presentation: present physical, present nonphysical, past physical, and past nonphysical. Only the "past" parameters were calculated for patients who had had a partner in the past but had no partner at the time of presentation. We used the chi2 test to determine individually significant predictors of the four parameters. Logistic-regression models were constructed to determine the significant predictors of DV. Associations among the present physical, present nonphysical, past physical, and past nonphysical abuse categories were determined with McNemar's test.
We enrolled 516 patients, 233 men and 283 women. On the basis of ISA scoring, 14% of men and 22% of women had experienced past nonphysical violence (P=.02, men versus women), and 28% of men and 33% of women had experienced past physical violence (P=.35). Of the 157 men and 207 women with partners at the time of presentation, 11% of men and 15% of women reported present nonphysical violence (P=.20), and 20% men and 19% of women reported present physical violence (P=.71). Using logistic-regression models, we determined that women experienced significantly more past and present nonphysical violence but not physical violence than men. For all four parameters, the victim's suicidal ideation and alcohol use were independently associated with DV. The victim's family history was strongly associated with past abuse. Using McNemar's test, we found that physical and nonphysical abuse were correlated in the past and present.
Using a validated scale, we found that the prevalences of physical DV for men and women are high and that they are not statistically different in this population. Using chi 2 testing, we found that women had experienced significantly more past nonphysical violence than men; using logistic regression we found that they experienced significantly more nonphysical violence (both past and present) than men. DV was frequently associated with suicidal ideation, alcohol use, and family history of violence.
确定急诊室（ED）男性和女性患者中家庭暴力（DV）的患病率，并确定家庭暴力的人口统计学特征。
本研究设计为对成年人的描述性书面调查。我们使用了配偶虐待指数（ISA），这是一种先前经过验证的调查工具。该研究在一个市中心的急诊室进行，每年约有75000名患者，其中大多数为贫困人口。纳入年龄在18岁及以上且能够给予知情同意的患者。如果患者存在语言障碍、是囚犯或从未有过伴侣，则将其排除。考虑对1995年7月随机选择的31个4小时轮班期间就诊的所有患者进行研究。根据ISA评分，家庭暴力被定义为身体暴力或非身体暴力。确定当前（前一年）和过去（超过1年前）虐待的患病率。为就诊时拥有伴侣的患者计算四个暴力参数：当前身体暴力、当前非身体暴力、过去身体暴力和过去非身体暴力。对于过去有伴侣但就诊时没有伴侣的患者，仅计算“过去”参数。我们使用卡方检验来确定四个参数各自的显著预测因素。构建逻辑回归模型以确定家庭暴力的显著预测因素。使用麦克尼马尔检验确定当前身体暴力、当前非身体暴力、过去身体暴力和过去非身体虐待类别之间的关联。
我们纳入了516名患者，其中233名男性和283名女性。根据ISA评分，14%的男性和22%的女性曾经历过过去的非身体暴力（男性与女性相比，P = 0.02），28%的男性和33%的女性曾经历过过去的身体暴力（P = 0.35）。在就诊时拥有伴侣的157名男性和207名女性中，11%的男性和15%的女性报告了当前的非身体暴力（P = 0.
