Preventive care in the emergency department: Screening for domestic violence in the emergency department
Preventive care in the emergency department: Screening for domestic violence in the emergency department
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DOI：
10.1197/s1069-6563(03)00371-3
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发表时间：
2003-10-01
影响因子：
4.4
通讯作者：
Sachs, C
中科院分区：
文献类型：
--
作者：
Anglin, D;Sachs, C
目的：在卫生保健环境中识别和管理家庭暴力(DV)受害者的最有效方法尚不清楚。这项研究的目的是系统地回顾急诊科(ED)对DV的筛查，以识别受害者，减少DV的发病率和死亡率。方法：使用术语“家庭暴力”或“伴侣暴力”、“识别”或“筛查”和“紧急”，作者检索了1980-2002年的MEDLINE、Cochrane数据库和急诊医学摘要。他们选择了研究筛查工具、干预措施或确定勃起功能障碍患者中DV发病率或流行率的文章。这些研究采用循证方法进行分析。结果：文献检索共339篇。根据遴选准则，45个获详细评审，其中17个与教育署有关。从这17篇文章的参考文献中，增加了3篇文章。可使用简短的口头筛选和现有的ED人员进行筛选。一项随机对照试验没有显示实验医院和对照医院之间筛查率的差异。没有研究评估ED筛查DV对家庭暴力发病率或死亡率的影响。一项以ED为基础的倡导计划导致了避难所和咨询服务的使用增加。结论：由于缺乏评估ED筛查和干预措施的结果研究，没有足够的证据支持或反对在ED中进行DV筛查。然而，由于DV造成的痛苦负担很大，卫生保健提供者应强烈考虑将询问DV作为病史的一部分，至少对所有女性青少年和成年患者如此。
Objectives: The most effective methods for identification and management of domestic violence (DV) victims in health care settings are unknown. The objective of this study was to systematically review screening for DV in the emergency department (ED) to identify victims and decrease morbidity and mortality from DV Methods: Using the terms "domestic violence" or "partner violence," and "identification" or "screening," and "emergency," the authors searched MEDLINE, the Cochrane Database, and Emergency Medical Abstracts from 1980-2002. They selected articles studying screening tools, interventions, or determining the incidence or prevalence of DV among ED patients. The studies were analyzed using evidence-based methodology. Results: Three hundred thirty-nine articles resulted from the literature search. Based on selection criteria, 45 were reviewed in detail and 17 pertained to the ED. From references of these 17 articles, three additional articles were added. Screening can be conducted using a brief verbal screen and existing ED personnel. A randomized, controlled trial did not demonstrate a difference in screening rates between experimental and control hospitals. No studies assessed the effect of ED screening for DV on morbidity or mortality of domestic violence. An ED-based advocacy program resulted in increased use of shelters and counseling. Conclusions: Because of the paucity of outcomes research evaluating ED screening and interventions, there is insufficient evidence for or against DV screening in the ED. However, because of the high burden of suffering caused by DV, health care providers should strongly consider routinely inquiring about DV as part of the history, at a minimum for all female adolescent and adult patients.