Accuracy of 3 brief screening questions for detecting partner violence in the emergency department
Accuracy of 3 brief screening questions for detecting partner violence in the emergency department
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DOI：
10.1001/jama.277.17.1357
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发表时间：
1997-05-07
影响因子：
120.7
通讯作者：
Abott, JT
中科院分区：
文献类型：
--
作者：
Feldhaus, KM;KoziolMcLain, J;Abott, JT
客观。-设计一个简短的筛查工具，以发现伴侣暴力行为，并根据既定工具部分验证这一筛查。前瞻性调查。设置。-两个城市，医院为基础的紧急部门。在48个随机选择的4小时时间段内，491名女性中有322名（76%的合格患者）参与了研究。受访者的平均年龄为36岁; 19%是黑人，45%是白色，30%是西班牙裔，而6%是其他种族或民族; 54%是保险。我们开发了一个伴侣暴力屏幕（PVS），包括3个问题，关于过去的身体暴力和感知的个人安全。我们管理的PVS和2个标准化措施的合作伙伴的暴力，指数配偶虐待（伊萨）和冲突策略量表（CTS）。将PVS的敏感性、特异性和预测值与伊萨和CTS作为标准进行比较。使用PVS的伴侣暴力发生率为29.5%（95%置信区间[CI]，24.6%-34.8%）。伊萨和CTS的患病率分别为24.3%（95%CI，19.2%-30.1%）和27.4%（95%CI，21.7%-33.6%）。与伊萨相比，PVS检测性伴侣虐待的敏感性为64.5%，特异性为80.3%。与CTS比较，PVS的敏感性为71.4%，特异性为84.4%。阳性预测值范围为51.3%至63.4%，阴性预测值范围为87.6%至88.7%。总体而言，13.7%的访问是由于急性发作的合作伙伴暴力。三个简短的定向问题可以发现大量有伴侣暴力史的妇女。
Objective.-To devise a brief screening instrument to detect partner violence and to partially validate this screen against established instruments.Design.-Prospective survey.Setting.-Two urban, hospital-based emergency departments.Participants.-Of 491 women presenting during 48 randomly selected 4-hour time blocks, 322 (76% of eligible patients) participated. Respondents had a median age of 36 years; 19% were black, 45% white, and 30% Hispanic, while 6% were of other racial or ethnic groups; 54% were insured.Interventions.-We developed a partner violence screen (PVS), consisting of 3 questions about past physical violence and perceived personal safety. We administered the PVS and 2 standardized measures of partner violence, the Index of Spouse Abuse (ISA) and the Conflict Tactics Scale (CTS).Main Outcome Measures.-Sensitivity, specificity, and predictive values of the PVS were compared with the ISA and the CTS as criterion standards.Results.-The prevalence rate of partner violence using the PVS was 29.5% (95% confidence interval [CI], 24.6%-34.8%). For the ISA and CTS, the prevalence rates were 24.3% (95% CI, 19.2%-30.1%) and 27.4% (95% CI, 21.7%-33.6%), respectively. Compared with the ISA, the sensitivity of the PVS in detecting partner abuse was 64.5%; the specificity was 80.3%. When compared with the CTS, sensitivity of the PVS was 71.4%; the specificity was 84.4%. Positive predictive values ranged from 51.3% to 63.4%, and negative predictive values ranged from 87.6% to 88.7%. Overall, 13.7% of visits were the result of acute episodes of partner violence.Conclusion.-Three brief directed questions can detect a large number of women who have a history of partner violence.