Screening Children for Family Violence: A Review of the Evidence for the US Preventive Services Task Force
Screening Children for Family Violence: A Review of the Evidence for the US Preventive Services Task Force
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筛查儿童是否有家庭暴力：美国预防服务工作组的证据审查
作者：
P. Nygren;H. Nelson;J. Klein
背景：我们想通过检查筛查工具的性能和干预措施的有效性的证据，评估在初级卫生保健机构中筛查儿童因家庭暴力而受到虐待和忽视的好处和危害。方法检索MEDLINE、PsycINFO、CINAHL、ERIC、科克伦对照试验数据库及参考文献。纳入了英文摘要，其中包含关于针对儿童的家庭暴力的原始数据，重点是在卫生保健机构发起或基于卫生保健机构的筛查和干预措施。我们提取了有关研究设计、患者人群和环境、评估或干预方法以及结局指标的选定信息，并应用了一套标准来评估研究质量。所有旨在筛查儿童虐待和忽视的工具都是针对父母的，特别是孕妇。这些工具在高风险研究人群中使用时具有相当高的灵敏度，但特异性较低，尚未在其他人群中进行广泛测试。在怀孕期间开始的针对行为和心理因素的频繁护士之家访问计划的随机对照试验表明，滥用措施和结果有所改善。没有发现关于年龄较大儿童的干预措施或与筛查和干预相关的危害的研究。结论：目前还没有关于在卫生保健环境中筛查有效性的试验发表。临床医生转介护士在怀孕期间和幼儿期的家庭访问可能会减少在选定的人群中的滥用。没有关于筛查和干预的危害的研究。
BACKGROUND We wanted to evaluate the benefits and harms of screening children in primary health care settings for abuse and neglect resulting from family violence by examining the evidence on the performance of screening instruments and the effectiveness of interventions. METHODS We searched for relevant studies in MEDLINE, PsycINFO, CINAHL, ERIC, Cochrane Controlled Trials Register, and reference lists. English language abstracts with original data about family violence against children focusing on screening and interventions initiated or based in health care settings were included. We extracted selected information about study design, patient populations and settings, methods of assessment or intervention, and outcome measures, and applied a set of criteria to evaluate study quality. RESULTS All instruments designed to screen for child abuse and neglect were directed to parents, particularly pregnant women. These instruments had fairly high sensitivity but low specificity when administered in high-risk study populations and have not been widely tested in other populations. Randomized controlled trials of frequent nurse home visitation programs beginning during pregnancy that address behavioral and psychological factors indicated improved abuse measures and outcomes. No studies were identified about interventions in older children or harms associated with screening and intervention. CONCLUSIONS No trials of the effectiveness of screening in a health care setting have been published. Clinician referrals to nurse home visitation during pregnancy and in early childhood may reduce abuse in selected populations. There are no studies about harms of screening and interventions.
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影响因子：
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作者：
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DOI：
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发表时间：
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期刊：
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影响因子：
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DOI：
--
发表时间：
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影响因子：
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影响因子：
8
作者：
Olds,DL;HendersonJr,CR;Kitzman,H
通讯作者：
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影响因子：
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作者：
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