Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits
Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits
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DOI：
10.1017/s0033291797006508
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发表时间：
1998-03-01
影响因子：
6.9
通讯作者：
Hu, YJB
中科院分区：
文献类型：
--
作者：
Leserman, J;Li, Z;Hu, YJB
背景尽管越来越多的文献指出性虐待和身体虐待史对健康的有害影响，但很少有研究提供证据证明哪些医学症状最受影响。本文的目的是确定性虐待和身体虐待的历史上的一组选定的医疗症状的影响，并测试如何虐待，医疗症状和功能障碍可能会影响随后的医疗保健visits. Methods。我们研究了239名来自一家以消化道为基础的胃肠病诊所的妇女;其中196名妇女的随访数据可用。所有妇女都接受了性虐待和身体虐待史的采访。有虐待史的妇女，特别是那些严重虐待的妇女，更有可能报告与恐慌有关的躯体症状（例如心悸、麻木、呼吸短促）、抑郁（如睡眠困难、食欲不振）、肌肉骨骼疾病（如头痛、肌肉疼痛）、泌尿生殖系统疾病（例如阴道分泌物、骨盆疼痛、性交疼痛）、皮肤不适（例如皮疹）和呼吸道疾病（例如鼻塞）。此外，我们发现，虐待史的严重程度，躯体症状和功能障碍预测30%的变异，在随后的一年里，在医疗保健访问，和虐待严重程度的影响，访问的解释是虐待妇女有更多的躯体症状和功能障碍。患者报告的虐待史、躯体症状和功能障碍似乎是解释胃肠道疾病妇女诊所抽样中保健就诊次数的重要因素。
Background. Despite a growing literature pointing to the deleterious health effects of sexual and physical abuse history, few studies provide evidence about which medical symptoms are most affected. The aim of this paper is to determine the impact of sexual and physical abuse history on a selected set of medical symptoms, and to test how such abuse, medical symptoms and functional disability may affect subsequent health care visits.Methods. We studied 239 women from a referral-based gastroenterology clinic; follow-up data were available on 196 of these women. All women were interviewed about sexual and physical abuse history.Results. Women with abuse history, particularly those with severe abuse, were much more likely to report somatic symptoms related to panic (e.g. palpitations, numbness, shortness of breath), depression (e.g. difficulty sleeping, loss of appetite), musculoskeletal disorders (e.g. headaches, muscle aches), genito-urinary disorders (e.g. vaginal discharge, pelvic pain, painful intercourse), skin disturbance (e.g. rash) and respiratory illness (e.g. stuffy nose). Furthermore, we found that the severity of abuse history, somatic symptoms and functional disability predicted 30% of the variance in health care visits during the subsequent year, and that the effect of abuse severity on visits was explained by abused women having more somatic symptoms and functional disability.Conclusions. Patients' reports of abuse history, somatic symptoms and functional disability appear to be important factors in explaining the number of health care visits among a clinic sample of women with gastrointestinal disorders.