Youth violence secondary prevention initiatives in emergency departments: a systematic review.

Youth violence secondary prevention initiatives in emergency departments: a systematic review.
复制标题

急诊科的青少年暴力二级预防举措：系统回顾。

DOI：
--
复制
发表时间：
2009
期刊：
CJEM
影响因子：
--
通讯作者：
J. Lee
J. Lee
中科院分区：
--
文献类型：
--
作者：
C. Snider;J. Lee

文献摘要

被引文献

相似文献

目的 青年暴力继续困扰加拿大人。急诊室（艾德）访问后，暴力伤害的青年可能是一个“可教的时刻，”因此，二级暴力预防干预措施可能是有效的。我们进行了一项系统性回顾，以确定任何干预措施的成功率，可能受益的人群和使用的结果指标。 数据源 我们检索了8个数据库（即，MEDLINE、EMBASE、PubMed、CINAHL、科克伦系统评价数据库、ACP期刊俱乐部、DARE和CENTRAL）。 资料选择 如果研究报告描述和评价了一项干预措施，以保健为基础，并针对因暴力而受伤的青年，则纳入研究报告。两位设盲研究者从181篇摘要中选择了15篇文章。全文检索后，排除8篇文献，剩余7篇文献来自4个干预项目。 数据提取 所有干预措施均采用艾德病例管理的暴力受伤的病人。一项随机对照试验（RCT）显示再损伤率显著降低（治疗组8.1% vs.对照组20.3%，p = 0.05）。另一项小型随机对照试验发现，重复暴力或服务使用没有统计学意义的减少。一项回顾性队列研究表明，未来参与刑事司法的相对风险（RR）较低（RR = 0.67，95%置信区间0.45-0.99）。一项对暴力伤害儿童患者的回顾性研究发现，这些年轻人中只有1%因重复暴力而受伤。 资料综合 虽然我们回顾的所有4种病例管理干预措施在美国都显示出了希望，但样本量小和随访不完整限制了他们证明再损伤显著减少的能力。 结论 未来的研究是必要的，以帮助ED利用机会，有效地减少青年暴力。
OBJECTIVE Youth violence continues to trouble Canadians. Emergency department (ED) visits by youth after a violent injury may represent a "teachable moment," and thus secondary violence prevention interventions may be effective. We conducted a systematic review to identify the success rates of any interventions, the populations likely to benefit and the outcome measures used. DATA SOURCE We searched 8 databases (i.e., MEDLINE, EMBASE, PubMed, CINAHL, the Cochrane Database of Systematic Reviews, the ACP Journal Club, DARE and CENTRAL). STUDY SELECTION Studies were included if they described and evaluated an intervention, were health care-based and targeted youth who were injured by violence. Two blinded investigators selected 15 articles from 181 abstracts. After full-text review, 8 articles were excluded, leaving 7 articles from 4 intervention programs. DATA EXTRACTION All interventions used ED case management of the violently injured patient. One randomized control trial (RCT) demonstrated a significant reduction in reinjury rates (treatment group 8.1% v. control group 20.3%, p = 0.05). Another small RCT found no statistically significant reductions in repeat violence or service use. One retrospective cohort study demonstrated a lower relative risk (RR) in future criminal justice involvement (RR = 0.67, 95% confidence interval 0.45-0.99). A retrospective study of pediatric patients with violent injuries found only 1% of these youth returned with injuries as a result of repeat violence. DATA SYNTHESIS Although all 4 case management interventions that we reviewed showed promise in the United States, small sample sizes and incomplete follow-up limited their ability to demonstrate significant decreases in reinjury. CONCLUSION Future research is necessary to help EDs capitalize on the opportunity to effectively reduce youth violence.