Victims of domestic violence on the trauma service: Unrecognized and underreported
Victims of domestic violence on the trauma service: Unrecognized and underreported
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DOI：
10.1097/01.ta.0000042021.47579.b6
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发表时间：
2003-02-01
影响因子：
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通讯作者：
Bilello, JF
中科院分区：
文献类型：
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作者：
Davis, JW;Parks, SN;Bilello, JF
背景。家庭暴力（DV）作为一种重要的伤害机制已得到越来越多的认可。为了提高我们机构对 DV 的认识，向外科和急诊医学部门提出了一项教育计划。进行了前测和后测，并证明了知识的提高。此外，在创伤史和体格 (H & P) 表格中添加了 DV 筛查问题。本研究旨在确定这些努力在提高对家庭暴力的认识以及将接受创伤服务的患者转介至社会服务方面的长期效果。经过教育和 H&P 形式的改变后，应加强对 DV 的认识和适当的转诊。方法：对 10 个月内在一级创伤中心接受创伤服务的所有患者进行回顾，并回顾其伤害“攻击”机制。根据院前报告和医疗记录中的信息，确定 DV 存在、可能、未知或不存在。对 DV 屏幕问题的使用和准确性进行了审查。结果。在研究期间，有 1,550 名患者被送往创伤服务中心，其中 217 名患者 (14%) 因袭击而受伤。 27 名患者（占袭击事件的 12.4%）已确诊或可能患有 DV。在确诊或可能患有 DV 的患者中，只有 7 人收到了适当的转诊，其中 2 人是由护理人员推荐的。在确诊和可能的 DV 患者中，有 17 人 (63%) 在没有进行安全调查的情况下被送回家，所有袭击受害者中只有 21% 接受过任何社会服务评估（通常是为了调查资金或安置）。仅 12 名患者使用了 DV 筛查。未能在 H&P 上完成 DV 屏幕的原因包括检查者在提出问题时感到不适，以及被认为不合适的环境（急诊室的复苏区）。结论：。 DV 未被识别且报告不足。需要继续努力提高对家庭暴力事件的认识和报告。作为初步评估的一部分，没有有效地进行 DV 筛查。 DV 评估作为第三次调查的一部分可能更合适。
Background. Domestic violence (DV) has received increased recognition as a significant mechanism of injury. To improve awareness about DV at our institution, an educational program was presented to the departments of surgery and emergency medicine. Pre and posttests were given and improvement in knowledge was demonstrated. In addition, a screening question for DV was added to the trauma history and physical (H & P) form. This study was done to determine the long-term efficacy of these efforts in increasing recognition of DV and referral to social services in patients admitted to the trauma service. Recognition of DV and appropriate referral should be increased after education and change in H & P form.Methods: All patients admitted to the trauma service at a Level I trauma center over a 10 month period with the mechanism of injury "assault" were reviewed. DV was determined to be present, likely, unknown, or absent based on information from the prehospital report and medical records. The DV screen question was reviewed for use and accuracy.Results. During the study period, 1,550 patients were admitted to the trauma service, with assault listed as the mechanism of injury for 217 (14%). DV was confirmed or likely in 27 patients (12.4% of the assaults). Of patients with confirmed or likely DV, only 7 received appropriate referrals, with 2 generated by the nursing staff. Of the confirmed and likely DV patients, 17 (63%) were sent home without investigation of safety and only 21% of all assault victims had any social services evaluation (usually to investigate funding or placement). The DV screen was used in only 12 patients. Reasons given for failure to complete the DV screen on the H & P included examiner discomfort in asking the question, and an environment judged to be inappropriate (resuscitation area in the emergency department).Conclusion:. DV is unrecognized and underreported. Efforts to improve recognition and reporting of DV events need to be ongoing. Screening for DV is not effectively done as part of the initial evaluation. Assessment for DV may be more appropriate as part of the tertiary survey.