Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies
Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies
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DOI：
10.1016/s0140-6736(11)61851-5
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发表时间：
2012-04-28
期刊：
影响因子：
168.9
通讯作者：
Officer, Alana
中科院分区：
文献类型：
--
作者：
Hughes, Karen;Bellis, Mark A.;Officer, Alana
背景全球约有15%的成年人有残疾。这些人经常被报告有更大的暴力风险，但对这一问题的研究缺乏定量的综合。方法在这项系统回顾和荟萃分析中，我们搜索了12个电子数据库，以确定1990年1月1日至2010年8月17日发表的初步研究报告，报告了对残疾成年人(主要年龄为&>=18岁)的暴力行为的流行率估计，或与非残疾成年人的暴力风险比较。我们只纳入了报告研究前12个月内发生暴力事件的研究。我们用6个核心质量标准对研究进行评估，并汇集数据进行分析。初步确定的10663篇参考文献中，26篇符合纳入条件，其中包括21557名残疾人的数据。21项研究提供了适用于暴力流行率元分析的数据，10项研究提供了暴力风险的元分析数据。精神疾病患者近期暴力行为的合并患病率为24.3%(95%可信区间18.3-31.0)，智力障碍患者为6.1%(2.5-11.1)，非特定障碍患者为3.2%(2.5-4.1)。我们在大多数患病率估计(I-2和GT；75%)中发现了实质性的异质性。我们注意到围绕集合风险估计的巨大不确定性。在所有研究中，残疾人与非残疾人暴力风险的合并粗略优势比为1.50(95%CI 1.09-2.05)，非特定障碍者为1.31(0.93-1.84)，智力障碍者为1.60(1.05-2.45)，精神病患者为3.86(0.91-16.43)。然而，现有的研究在方法上存在缺陷，在所处理的残疾和暴力类型方面存在差距。对于世界上大多数地区，尤其是低收入和中等收入国家，缺乏强有力的研究。
Background About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.Methods In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly >= 18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.Findings Of 10 663 references initially identified, 26 were eligible for inclusion, with data for 21 557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24.3% (95% CI 18.3-31.0) in people with mental illnesses, 6.1% (2.5-11.1) in those with intellectual impairments, and 3.2% (2.5-4.1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I-2 > 75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1.50 (95% CI 1.09-2.05) for all studies combined, 1.31 (0.93-1.84) for people with non-specific impairments, 1.60 (1.05-2.45) for people with intellectual impairments, and 3.86 (0.91-16.43) for those with mental illnesses.Interpretation Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.