医療施設における親密なパートナーによる暴力のスクリーニング:ランダム化試験
Harriet L MacMillan1, C Nadine Wathen, Ellen Jamieson
1Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Patterson Bldg, 1200 Main St W, Hamilton, ON L8N 3Z5, Canada. macmilnh@mcmaster.ca
JAMA
|August 6, 2009
まとめ
医療施設での親密なパートナーによる暴力 (IPV) のスクリーニングは,女性に対する暴力を大幅に軽減したり,生活の質を向上させなかった. IPVを患っている女性のためのサービスを評価するために,さらなる研究が必要である.
科学分野:
- 公衆衛生は公衆衛生である.
- クリニカル・メディシン 臨床医学
- 女性の健康 女性の健康
背景:
- 暴力の減少と女性の健康状態の改善における親密なパートナー暴力 (IPV) のスクリーニングの有効性は不明である.
- IPVの定期的なスクリーニングは,さまざまな医療環境で実施されていますが,その影響は厳格な評価を必要とします.
研究 の 目的:
- IPVスクリーニングの有効性を評価し,医療機関における臨床医に陽性結果の伝達を行う.
- IPVスクリーニングが,女性における暴力の再発と生活の質に影響を与えるかどうかを判断する.
主な方法:
- カナダのオンタリオ州で100以上の医療施設でランダム化制御試験を実施し,18歳から64歳までの6743人の女性が参加しました.
- 参加者は,女性虐待スクリーニングツール (WAST) を使用してスクリーニングされたグループ (n=3271) にランダムに割り当てられ,結果は臨床医に報告され,スクリーニングされていないグループ (n=3472) に割り当てられました.
- プライマリアウトカムには,IPV再暴露と生活の質が含まれ,インタビューを通じて18ヶ月間評価されました.
主要な成果:
- 高い参加者減退率 (41-43%) は,研究の力に影響を与え,研究結果の慎重な解釈を必要とした.
- 18ヶ月で,スクリーニングされたグループとスクリーニングされていないグループ (スクリーニングされたグループとスクリーニングされなかったグループ) の間でIPV再発の統計的に有意な違いは観察されなかった (46%対53%).
- 検診を受けた女性は生活の質の向上に向けた傾向を示したが,この違いは欠けているデータを考慮した後に有意ではなかった.
結論:
- この研究は,医療機関におけるIPVスクリーニングのルーティン実施を支持する十分な証拠を提供しなかった.
- 否定的な結果にもかかわらず,IPVと診断された女性のための効果的なサービスの必要性は,公衆衛生上の重要な優先事項であり続けています.
- 将来の研究は,親密なパートナーによる暴力の被害者のためのサポートシステムと介入の最適化に焦点を当てなければならない.
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