Read J, Fraser A
Psychology Department, University of Auckland, New Zealand.
Aust N Z J Psychiatry. 1998 Apr;32(2):206-13. doi: 10.3109/00048679809062730.
In the context of numerous studies demonstrating that a significant proportion of psychiatric inpatients have been sexually or physically abused at some point in their lives this study ascertained the responses of staff in a psychiatric inpatient unit to knowledge that patients had been subjected to sexual or physical abuse, in childhood or adulthood.
The medical records of 100 consecutive admissions were examined. Staff response was measured in terms of: (i) acquiring information about previous treatment for, or disclosure of, abuse; (ii) providing information, support or counselling during hospitalisation; (iii) reporting to legal authorities; and (iv) referring for ongoing abuse counselling.
Of the 32 patients who were documented as having disclosed abuse 11 files included documentation of previous treatment or disclosure; none were reported to have received support, counselling or information while in hospital; and three referrals were made for ongoing counselling. None of the 52 separate instances of abuse were reported to the authorities. Demographic, diagnostic, clinical and treatment variables, as well as the four abuse categories, were analysed for possible linkage to probability of staff response in each of the four response categories.
It was hypothesised that the low staff response rate is not unique to the particular unit evaluated here. Recommendations are offered regarding the need for unit policies ensuring routine abuse inquiry and for staff training about how to respond to abuse disclosures.
众多研究表明，相当一部分精神科住院患者在其生命中的某个阶段遭受过性虐待或身体虐待。本研究确定了精神科住院单元的工作人员对患者在童年或成年期遭受性虐待或身体虐待这一情况的反应。
检查了连续100例入院患者的病历。工作人员的反应通过以下方面衡量：（i）获取有关既往虐待治疗或披露情况的信息；（ii）在住院期间提供信息、支持或咨询；（iii）向法律当局报告；（iv）转介接受持续的虐待咨询。
在记录有虐待披露情况的32例患者中，11份档案包含既往治疗或披露的记录；住院期间无人报告接受过支持、咨询或信息；有3例被转介接受持续咨询。52起单独的虐待事件均未向当局报告。分析了人口统计学、诊断、临床和治疗变量，以及四类虐待情况，以探讨它们与工作人员在四个反应类别中做出反应的可能性之间的潜在联系。
据推测，工作人员的低反应率并非此处所评估的特定单元所独有。针对制定确保常规虐待调查的单元政策以及对工作人员进行如何应对虐待披露的培训提出了建议。
