对亲密伴侣虐待的查和干预:初级保健医生的做法和态度
M A Rodriguez1, H M Bauer, E McLoughlin
1The Pacific Center for Violence Prevention, Department of Family and Community Medicine, University of California, San Francisco, USA. rodrigu@itsa.ucsf.edu
JAMA
|August 12, 1999
概括
初级保健医生经常选受伤患者的亲密伴侣虐待,但在例行访问期间错过了机会. 改善查实践对于患者安全和遵守指南至关重要.
科学领域:
- 公共卫生 公共卫生
- 医学实践 医学实践
- 社会医学科学 社会医学科学
背景情况:
- 亲密伴侣虐待 (IPA) 查的实践指南存在,但医生遵守和遵守的情况尚未得到充分理解.
- IPA是一个重要的公共卫生问题,需要在医疗机构内制定有效的查和干预策略.
研究的目的:
- 调查初级保健医生关于亲密伴侣虐待的查实践和干预感知.
- 在各种临床场景中确定影响医生遵守IPA查指南的因素.
主要方法:
- 在加利福尼亚州,582名符合条件的初级保健医生 (家庭医学,内科,产科/妇科) 中进行了横截面调查.
- 一份24项问卷评估了报告的IPA查实践,干预措施和感知障碍,并根据医生人口统计和实践环境分析了数据.
主要成果:
- 大多数医生 (79%) 常规查受伤患者的IPA,但在新患者访问 (10%),检查 (9%) 和产前护理 (11%),常规查较少.
- 妇产科医生和公共诊所的妇产科医生更有可能对新患者进行查,而内科医生和HMO的内科医生最不可能.
- 常见的干预措施包括表达对安全的担忧 (91%),转介到庇护所 (79%) 和咨询 (88%),以及图表文件 (89%). 主要障碍包括患者的恐惧 (82%),缺乏披露 (78%) 和后续问题 (52%).
结论:
- 初级保健医生在各种临床接触中错过了IPA查的机会,这表明指导方针和实践之间存在差距.
- 需要进一步的研究来制定有效的干预策略,并加强医生遵守IPA查指南.
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