Recognizing Intimate Partner Violence in Primary Care: Western Cape, South Africa
Recognizing Intimate Partner Violence in Primary Care: Western Cape, South Africa
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DOI：
10.1371/journal.pone.0029540
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发表时间：
2012-01-05
期刊：
影响因子：
3.7
通讯作者：
Mash, Robert
中科院分区：
文献类型：
--
作者：
Joyner, Kate;Mash, Robert
简介：在南非，人际暴力是继艾滋病毒/艾滋病之后造成疾病负担的第二大因素，据估计 62% 是由亲密伴侣暴力 (IPV) 造成的。本研究旨在评估感染 IPV 的女性在初级保健中的表现、卫生保健从业人员识别 IPV 的频率以及做出哪些其他诊断。 方法：在两个城市和三个农村社区卫生中心，卫生从业人员接受了培训，以在长达 8 周的时间内对所有妇女进行 IPV 筛查。随后检查了 114 名女性的医疗记录，并使用国际初级保健分类对她们过去 2 年的就诊原因 (RFE) 和诊断进行了编码。对从业人员进行了 3 次焦点小组访谈，并与设施管理人员进行了访谈，以探讨他们的筛查经验。 结果：之前有 11 名女性 (9.6%) 发现了 IPV。提出各种 RFE 的女性应提高对 IPV 头痛、需要精神药物治疗、睡眠障碍、疲倦、攻击、感到焦虑和抑郁的怀疑指数。抑郁症是最常见的诊断。访谈发现了阻碍卫生从业人员进行筛查的关键问题。结论：这项研究表明，南非初级保健机构对患有 IPV 的女性的认可度非常低，并增加了有关女性如何接受流动医疗服务的有用的新信息。这些发现提供了关键线索，可用于改善资源匮乏地区 IPV 的选择性病例发现。本研究不支持普遍筛查。
Introduction: Interpersonal violence in South Africa is the second highest contributor to the burden of disease after HIV/AIDS and 62% is estimated to be from intimate partner violence (IPV). This study aimed to evaluate how women experiencing IPV present in primary care, how often IPV is recognized by health care practitioners and what other diagnoses are made.Methods: At two urban and three rural community health centres, health practitioners were trained to screen all women for IPV over a period of up to 8 weeks. Medical records of 114 thus identified women were then examined and their reasons for encounter (RFE) and diagnoses over the previous 2-years were coded using the International Classification of Primary Care. Three focus group interviews were held with the practitioners and interviews with the facility managers to explore their experience of screening.Results: IPV was previously recognized in 11 women (9.6%). Women presented with a variety of RFE that should raise the index of suspicion for IPV- headache, request for psychiatric medication, sleep disturbance, tiredness, assault, feeling anxious and depressed. Depression was the commonest diagnosis. Interviews identified key issues that prevented health practitioners from screening.Conclusion: This study demonstrated that recognition of women with IPV is very low in South African primary care and adds useful new information on how women present to ambulatory health services. These findings offer key cues that can be used to improve selective case finding for IPV in resource-poor settings. Universal screening was not supported by this study.