Screening for intimate partner violence in a pediatric primary care clinic
Screening for intimate partner violence in a pediatric primary care clinic
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DOI：
10.1542/peds.2007-0904
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发表时间：
2008-01-01
期刊：
影响因子：
8
通讯作者：
Kim, Jeongeun
中科院分区：
文献类型：
--
作者：
Dubowitz, Howard;Prescott, Leslie;Kim, Jeongeun
目标。目的评估儿科初级保健诊所父母亲密伴侣暴力的患病率，评价简易亲密伴侣暴力筛查方法的稳定性、敏感性、特异性、阳性预测值、阴性预测值和似然比。方法对200名6岁以下儿童的父母(主要为母亲)在初级保健诊所完成父母筛查问卷调查。父母筛选问卷是为这项研究开发的一种简短的心理社会问题筛查工具，包括3个关于亲密伴侣暴力的问题。母亲们随后在两个月内完成了计算机化的研究方案。这包括父母筛选问卷以及修订后的冲突策略量表。亲密伴侣暴力问题的不同组合被对照修订的冲突策略量表进行评估。结果总共有12.0%的母亲对至少一个筛查问题的回答是肯定的。在标准化修订的冲突战术量表上，从9%的人报告在过去一年中受到身体伤害到76%的人报告心理攻击。筛查问题具有一定的稳定性。一个简单的问题，“你有没有在一段关系中受到过伴侣的身体伤害或威胁？”关于“身体伤害”，修订的冲突战术量表是最有效的。敏感性为29%，特异性为92%，阳性预测值为41%，阴性预测值为88%。阳性似然比为3.8，阴性似然比为0.77。结论亲密伴侣暴力是一个普遍存在的问题。一个非常简短的筛查就可以合理地确定哪些母亲可以从额外的评估和可能的服务中受益。需要更多的研究来寻找更敏感的筛查，并检查识别亲密伴侣暴力是否会导致有利于母亲、家庭和儿童的干预措施。
OBJECTIVES. To estimate the prevalence of intimate partner violence among parents at a pediatric primary care clinic and to evaluate the stability, sensitivity, specificity, positive and negative predictive values, and likelihood ratios of a very brief screen for intimate partner violence.METHODS. A total of 200 parents ( mostly mothers) bringing in children less than 6 years of age for child health supervision completed the Parent Screening Questionnaire in a primary care clinic. The Parent Screening Questionnaire, a brief screen for psychosocial problems developed for the study, includes 3 questions on intimate partner violence. Mothers then completed the computerized study protocol within 2 months. This included the Parent Screening Questionnaire as well as the Revised Conflict Tactics Scale. Different combinations of the intimate partner violence questions were evaluated against the Revised Conflict Tactics Scale.RESULTS. A total of 12.0% of the mothers answered "yes" to at least one of the screening questions. On the standardized Revised Conflict Tactics Scale, responses ranged from 9% reporting a physical injury in the past year to 76% reporting psychological aggression. There was moderate stability of the screening questions. A single question, "Have you ever been in a relationship in which you were physically hurt or threatened by a partner?" in relation to the "physically injured" Revised Conflict Tactics Scale subscale was most effective. Sensitivity was 29%, specificity was 92%, positive predictive value was 41%, and negative predictive value was 88%. The positive likelihood ratio was 3.8, and the negative likelihood ratio was 0.77.CONCLUSIONS. Intimate partner violence is a prevalent problem. A very brief screen can reasonably identify some mothers who could benefit from additional evaluation and possible services. Additional research is needed to find a more sensitive screen and to examine whether identifying intimate partner violence leads to interventions that benefit mothers, families, and children.