Intimate Partner Violence

亲密伴侣暴力
  • 文章类型: Journal Article
    背景:家庭暴力,其中包括亲密伴侣的虐待,虐待儿童,还有虐待老人,是一个严重的公共卫生问题。初级医疗保健(PHC)提供了识别和解决家庭暴力的重要机会,然而,障碍阻碍了在PHC环境中有效实施家庭暴力干预措施。这项研究的目的是通过探索准备因素来改善艾伯塔省PHC环境中的家庭暴力识别和反应。
    方法:综合知识翻译方法,将实施科学和参与行动研究相结合,用于开发准备情况评估工具,以解决艾伯塔省PHC环境中的家庭暴力问题。该研究涉及三个阶段:第一阶段涉及快速证据评估,第二阶段聘请了一个医疗保健和家庭暴力专家小组,探讨艾伯塔省背景下的准备工作要素,第三阶段利用了三轮Delphi共识建立过程来完善准备指标。
    结果:来自快速证据评估的第一阶段结果强调了评估在PHC环境中实施家庭暴力干预措施的五个主要模型/工具。在第二阶段,通过与医疗保健和家庭暴力专家小组成员的探索确定了其他概念,产生了总共16个概念,用于评估艾伯塔省PHC背景下的家庭暴力准备情况。第三阶段的3轮Delphi共识建立过程涉及9名小组成员,他们集体同意纳入所有概念和指标,为拟议的准备情况评估工具提供了60个项目,用于解决艾伯塔省PHC中的家庭暴力问题。
    结论:当前的研究为未来的家庭暴力干预计划奠定了基础,提供对关键组成部分的见解,以促进实施全面计划和支持PHC组织有效解决家庭暴力的准备。
    BACKGROUND: Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta\'s PHC settings by exploring readiness factors.
    METHODS: An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators.
    RESULTS: Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta.
    CONCLUSIONS: The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence.
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  • 文章类型: Journal Article
    通过TelementalHealth(TMH)提供治疗服务,或者远程治疗,自COVID-19大流行以来呈指数增长。尽管先前的研究表明TMH与面对面治疗一样有效,关于治疗师应如何解决因TMH引起的技术滥用和亲密伴侣暴力(IPV)问题的研究缺乏。考虑到暴力在浪漫关系中发生的频率,这是非常有问题的。本手稿旨在通过根据现有文献和从事TMH服务的专业经验提供具体的临床指南来解决这一差距。作者回顾了有关技术滥用的文献,并讨论了通过调整以家庭暴力为重点的夫妻治疗方案来评估和治疗TMH上的IPV的创新方法。在这里面,作者整合了对高冲突夫妇的研究,为如何管理快速升级和容易发生暴力的夫妇提供了新的建议。该手稿将总结未来的研究方向。
    Providing therapy services via Telemental Health (TMH), or teletherapy, has exponentially increased since the COVID-19 pandemic. Although previous research demonstrates that TMH is as effective as in-person therapy, there is a dearth of research on how therapists should address technology-perpetrated abuse and intimate partner violence (IPV) over TMH. This is extremely problematic given the frequency in which violence occurs in romantic relationships. This manuscript aims to address this gap by providing concrete clinical guidelines based on existing literature and professional experience with engaging in TMH services. The authors review literature on technology-perpetrated abuse and discuss innovative ways to assess and treat IPV over TMH by adapting protocols from Domestic Violence-Focused Couple\'s Therapy. Within this, the authors integrate research on high-conflict couples to provide new suggestions on how to manage couples who escalate quickly and who are prone to violence. The manuscript will conclude with future directions for research.
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  • 文章类型: Journal Article
    关于酒精对身体的健康影响,酒精的使用正受到越来越多的审查。在这种情况下,在过去十年中,一些高收入国家发布了低风险饮酒指南,旨在教育公众更安全的饮酒水平。关于酒精对特定性别健康影响的研究表明,女性对酒精的损害较高,酒精含量较低,男性和女性体内酒精的药代动力学存在总体性别差异。性别相关因素研究,虽然文化上依赖,表明对性侵犯和亲密伴侣暴力的敏感性增加,以及对女性饮酒的负面性别规范和陈规定型观念增加。一些国家发布了针对性别的和针对性别的准则,这表明女性的饮酒量低于男性;然而,在其他国家,已经发布了性别和性别盲目的建议。本文报告了有关性别和性别相关因素影响更安全饮酒水平的证据的综合,重点是女性的使用。我们得出的结论是,支持和扩大针对性别和性别的低风险饮酒指南的制定,为临床医生和消费者提供了更细致入微的教育信息,尤其有利于妇女和女孩。
    Alcohol use is coming under increasing scrutiny with respect to its health impacts on the body. In this vein, several high-income countries have issued low-risk drinking guidelines in the past decade, aiming to educate the public on safer levels of alcohol use. Research on the sex-specific health effects of alcohol has indicated higher damage with lower amounts of alcohol for females as well as overall sex differences in the pharmacokinetics of alcohol in male and female bodies. Research on gender-related factors, while culturally dependent, indicates increased susceptibility to sexual assault and intimate partner violence as well as more negative gender norms and stereotypes about alcohol use for women. Sex- and gender-specific guidelines have been issued in some countries, suggesting lower amounts of alcohol consumption for women than men; however, in other countries, sex- and gender-blind advice has been issued. This article reports on a synthesis of the evidence on both sex- and gender-related factors affecting safer levels of drinking alcohol with an emphasis on women\'s use. We conclude that supporting and expanding the development of sex- and gender-specific low-risk drinking guidelines offers more nuanced and educative information to clinicians and consumers and will particularly benefit women and girls.
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  • 文章类型: Systematic Review
    通过心理健康评估亲密伴侣暴力(IPV),medical,刑事司法从业人员经常发生。他们使用的评估工具的有效性会影响从业人员判断持续风险的能力,确定发生IPV的类型,保护潜在的受害者,并进行有效干预。然而,没有已知的现有评估措施汇编。本文的目的有三个:(1)对用于识别或预测IPV的措施进行系统的回顾,(2)确定这些措施中的哪些具有支持其使用的心理测量证据,和(3)确定任何现有措施是否能够区分情境性夫妻暴力和亲密恐怖主义。使用PsycINFO进行了系统搜索,心术,PubMed,和MEDLINE。包括IPV具体措施的信度或效度研究,无论格式如何,长度,纪律,或评估的IPV类型。共222项研究,关于87种独特度量的心理测量学特性,符合我们的先验标准,并被纳入审查。我们描述了87项措施的信度和效度。我们根据《基于共识的健康测量仪器选择标准》修订的标准和其他既定的有效性标准对措施进行了评级,这使我们能够生成建议措施的列表。我们还讨论了旨在区分IPV类型的措施。最后,我们描述了现有措施的优缺点,并为研究人员提出了加强IPV评估的新途径。
    The assessment of intimate partner violence (IPV) by mental health, medical, and criminal justice practitioners occurs routinely. The validity of the assessment instrument they use impacts practitioners\' ability to judge ongoing risk, establish the type of IPV occurring, protect potential victims, and intervene effectively. Yet, there is no known compendium of existing assessment measures. The purpose of this article is threefold: (1) to present a systematic review of measures used to identify or predict IPV, (2) to determine which of these measures have psychometric evidence to support their use, and (3) to determine whether any existing measure is capable of differentiating between situational couple violence and intimate terrorism. A systematic search was conducted using PsycINFO, PsycARTICLES, PubMed, and MEDLINE. Studies on the reliability or validity of specific measures of IPV were included, regardless of format, length, discipline, or type of IPV assessed. A total of 222 studies, on the psychometric properties of 87 unique measures, met our a priori criteria and were included in the review. We described the reliability and validity of the 87 measures. We rated the measures based on the Consensus-based Standards for the Selection of Health Measurement Instruments-revised criteria and other established validity criteria, which allowed us to generate a list of recommended measures. We also discussed measures designed to differentiate IPV types. We conclude by describing the strengths and weaknesses of existing measures and by suggesting new avenues for researchers to enhance the assessment of IPV.
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  • 文章类型: Journal Article
    The coronavirus disease 2019 (COVID-19) pandemic has contributed to an increase in intimate partner violence (IPV), posing challenges to health care providers who must protect themselves and others during sexual assault examinations. Victims of sexual assault encountered in prehospital and emergency department (ED) settings have legal as well as medical needs. A series of procedures must be carefully followed to facilitate forensic evidence collection and law enforcement investigation. A literature review detected a paucity of published guidance on the management of sexual assault patients in the ED, and no information specific to COVID-19.
    Investigators sought to update the San Diego County sexual assault guidelines, created in collaboration with health care professionals, forensic specialists, and law enforcement, through a consensus iterative review process. An additional objective was to create a SAFET-I Tool for use by frontline providers during the COVID-19 pandemic.
    The authors present a novel SAFET-I Tool that outlines the following five components of effective sexual assault patient care: stabilization, alert system activation, forensic evidence consideration, expedited post-assault treatment, and trauma-informed care. This framework can be used as an educational tool and template for agencies interested in developing or adapting existing sexual assault policies.
    There is a lack of clinical guidance for ED providers that integrates the many aspects of sexual assault patient care, particularly during the COVID-19 pandemic. A SAFET-I Tool is presented to assist emergency health care providers in the treatment and advocacy of sexual assault patients during a period with increasing rates of IPV.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:自2013年以来,南非约有4400名妇女被伴侣谋杀。这比全球人均平均水平高出五倍。众所周知,家庭暴力是周期性的,地方病,经常涉及多个受害者。随着时间的推移,它也会变得越来越危险,并可能导致死亡。2012年,南非卫生职业委员会发布了针对紧急服务提供者的家庭暴力协议。这个协议,或筛查指南,包括评估未来家庭暴力的风险,提供身体和心理护理,记录虐待证据,并告知患者他们的权利和他们可以获得的服务。这些准则的分发和执行程度,特别是由全科医生(HCP),是未知的。
    目的:我们审查南非签署的国际条约,以及加强照顾家庭暴力受害者权利的国家立法和政策,描述这些法律和政策对HCPs的影响。
    方法:我们回顾了文献并分析了国家和国际立法和政策。
    结果:现有指南中包含的、目前以临时方式实施的“规范”不仅与HCP的现有法定职责兼容,而且实际上是它们的自然扩展。
    结论:积极的干预措施,例如使用与家庭暴力受害者合作的准则,可以系统地识别可疑的家庭暴力案件,管理得当,适当引用,并应被所有南非HCP采用。
    BACKGROUND: Since 2013, approximately 4400 women have been murdered by their partners in South Africa. This is five times higher than the per capita global average. Domestic violence is known to be cyclical, endemic and frequently involves multiple victims. It also becomes progressively more dangerous over time and may lead to fatalities. In 2012, the Health Professions Council of South Africa released a domestic violence protocol for emergency service providers. This protocol, or screening guidelines, includes assessing future risk to domestic violence, providing physical and psychosocial care, documentation of evidence of abuse and informing patients of their rights and the services available to them. The extent to which these guidelines have been circulated and implemented, particularly by general health care practitioners (HCPs), is unknown.
    OBJECTIVE: We review international treaties to which South Africa is a signatory, as well as national legislation and policies that reinforce the right to care for victims of domestic violence, to delineate the implication of these laws and policies for HCPs.
    METHODS: We reviewed literature and analysed national and international legislation and policies.
    RESULTS: The \'norms\' contained in existing guidelines and currently practiced in an ad hoc manner are not only compatible with existing statutory duties of HCPs but are in fact a natural extension of them.
    CONCLUSIONS: Proactive interventions such as the use of guidelines for working with victims of domestic violence enable suspected cases of domestic violence to be systematically identified, appropriately managed, properly referred, and should be adopted by all South African HCPs.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    Domestic violence and sexual violence are widespread and have serious health effects for those affected. If the problem is identified and confidence in responding exists, healthcare providers can make a significant contribution to support and intervention. In 2013 the WHO published evidence-based guidelines for responding to the issue in healthcare, training of healthcare providers and health policy. In principle, the guidelines confirm existing recommendations, best-practice guidelines and handbooks. They also encourage a review and further development-for example, regarding the issue of sexual violence. If and how the present recommendations are put into practice in healthcare and training of healthcare staff can currently be looked at only with the use of examples, given the lack of data in Germany. Examples from Berlin show that implementation is quite possible. However, there is a lack of clear mandate, of sustainability and of obligation. Existing good practice models are highly reliant on organisations\' and employees\' commitment. For Germany, the WHO guidelines indicate the need to develop national standards for healthcare in cases of domestic and sexual violence. A (legal) obligation for the healthcare system should be drawn up. A systematic embedding in training curricula of health care professions is needed. Quality assurance and a systematic evaluation of the practical implementation are required.
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  • 文章类型: Journal Article
    BACKGROUND: Violence against women is a global public health problem with negative effects on physical, mental, and reproductive health. The World Health Organization (WHO) has identified intimate partner violence (IPV) and sexual violence (SV) as major targets for prevention and amelioration and recently developed clinical and policy guidelines to assist healthcare providers. This project was undertaken to determine the 2013 baseline national policies and clinical guidelines on IPV and SV within the Latin American and Caribbean (LAC) region to identify strengths and gaps requiring action.
    METHODS: Each Pan American Health Organization/World Health Organization Regional Office for the Americas (PAHO/WHO) country focal point was contacted to request their current national policy and clinical guidelines (protocol) on IPV/SV. We augmented this by searching the internet and the United Nations Women website. Each country\'s policy and clinical guideline (where available) was reviewed and entered into a scoring matrix based on WHO Clinical and Policy Guidelines. A total score for each heading and subheading was developed by adding positive responses to identify LAC regional strengths and gaps.
    RESULTS: We obtained 15 national policies and 12 national clinical guidelines (protocols) from a total of 18 countries (\"response\" rate 66.7%). National policies were comprehensive in terms of physical, emotional, and sexual violence and recommended good intersectoral collaboration. The greatest gap was in the training of health-care providers. National Guidelines for women-centered care for IPV/SV survivors were strong in the vital areas of privacy, confidentiality, danger assessment, safety planning, and supportive reactions to disclosure. The largest gaps noted were again in training healthcare professionals and strengthening monitoring and evaluation of services.
    CONCLUSIONS: Baseline measurement of policy and clinical guidelines for IPV/SV in LAC PAHO/WHO member countries at the time of issuing the 2013 WHO Clinical and Policy Guidelines reveals some important strengths, but also serious gaps that need to be addressed. The most pressing needs are for concerted training initiatives for healthcare providers and strengthening multisectoral monitoring and evaluation of services. A future evaluation of national policies, clinical guidelines, monitoring and evaluation will need to be conducted to measure the progress of the required scaling-up process.
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