Violent Injuries among Women in an Urban Area

Grisso, Jeane Ann; Schwarz, Donald F.; Hirschinger, Nancy; Sammel, Mary D.; Brensinger, Colleen M.; Santanna, Jill; Lowe, Robert A.; Anderson, Elijah; Shaw, Leslie M.; Bethel, Courtney A.; Teeple, Leslie

doi:10.1056/nejm199912163412506

Cited by 180 publications

(128 citation statements)

References 27 publications

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“…These are congruent with existing evidence showing an increased frequency of complications in pregnancy and childbirth, gynecological problems, sexually transmitted diseases, HIV, chronic somatic disorders, exacerbation of chronic medical problems, non-adherence to medical care, depression, anxiety and suicide, eating disorders, alcoholism, and substance use in women who have been abused. 14,18,25,29,30 Domestic abuse is found in all socioeconomic and cultural groups. 29,31,32 Similarly, no difference was found in the demographic characteristics in this sample in age, ethnicity, marital status, education, or employment.…”

Section: Discussionmentioning

confidence: 99%

“…A list of possible clinical diagnoses related to domestic violence was generated from the literature. 18,19 From this, the clinical presentations chosen, including several other categories commonly associated with emotional stress, were: 1) trauma, 2) obstetrical and gynecological syndromes, 3) psychiatric symptoms, 4) substance use, 5) abdominal pain, 6) somatic complaints, 7) nonabdominal pain syndromes, 8) asthma, and 9) others.…”

Section: Study Protocolmentioning

confidence: 99%

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Domestic Abuse in the Emergency Department: Can a Risk Profile Be Defined?

Zachary

Mulvihill

Burton

et al. 2001

Academic Emergency Medicine

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Abstract. Objectives:The main purpose of this study was to determine whether any clinical or demographic characteristics could identify adult female patients presenting to the emergency department (ED) with a history of domestic abuse. A second objective was to describe the frequency, types, and severity of this abuse. Methods: This study was a crosssectional survey of 611 women conducted in an academically-affiliated, urban ED. Domestic abuse was described as ''recent'' (within the preceding 12 months) or ''lifetime'' (recent or past). This included emotional, physical, and sexual abuse. Results: Recent (7.9%, n = 48) and lifetime (38%, n = 232) domestic abuse was reported. For recently abused women, violence had been severe (87.5%, n = 42) and was associated with 1) trauma (OR 5.4, 95% CI = 2.6 to 11.6), 2) obstetrical and gynecological syndromes (OR 5.6, 95% CI = 2.4 to 13.2), and 3) psychiatric symptoms and substance use (OR 7.3, 95% CI = 2.4 to 22.0). The sensitivities and positive predictive values of these risk factors individually (<27.1% and <25.0%, respectively) and in aggregate (56.3% and 20.9%, respectively) were low. These indicators predicted only 27 (56.3%) of recently abused women. Lifetime domestic violence was more likely in homeless women (OR 5.8, 95% CI = 2.2 to 15.0), although less likely in immigrants (OR 0.4, 95% CI = 0.3 to 0.7). Conclusions: Clinical presentations and demographic characteristics of women presenting to the ED may not be sensitive or predictive indicators of domestic abuse. In the absence of typical clinical or demographic findings, asking all women in the ED about domestic abuse remains a necessary priority. Key words: domestic violence; screening; physician's role; risk factors; partner abuse. ACADEMIC EMER- GENCY MEDICINE 2001; 8:796-803 I N 1992, the American Medical Association published guidelines recommending that medical providers routinely ask all women direct, specific questions about abuse.1 Subsequently, many national medical associations have developed similar guidelines.2-6 Despite these intentions, these recommendations have been fraught with difficulty and remain largely unrealized. Most physicians in the emergency department (ED), as in most settings, do not routinely ask their patients about domestic abuse.7,8 A recent study showed that fewer than 10% of primary care physicians in California routinely take a history about abuse. 9 In the ED, clinicians may be more likely to ask about abuse in women who present with assault-related inju- 10,11 However, women with acute presentations of domestic abuse often do not present with injuries. 12-14The complexity of routinely inquiring about domestic abuse in medical settings has been described. 10,15 Asking all women about this problem may be unrealistic, screening standards are not uniform, and few studies have evaluated the effectiveness of these efforts. However, several programs have achieved the goal of universal screening. 16 In addition, experts assert, and a small body of evidence suggests, that wome...

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Section: Discussionmentioning

confidence: 99%

Section: Study Protocolmentioning

confidence: 99%

Domestic Abuse in the Emergency Department: Can a Risk Profile Be Defined?

Zachary

Mulvihill

Burton

et al. 2001

Academic Emergency Medicine

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“…2 Living in a disadvantaged neighborhood, defined using census indicators of deprivation, has been associated with a variety of health behaviors such as gambling 3 and perinatal substance use 4 as well as health intermediates, including late stage cancer diagnoses, 5,6 pediatric injury, 7 partner violence, 8 and violent injuries to women. 9 Living in deprived neighborhood environments has further been associated with health outcomes such as cardiovascular disease, [10][11][12][13] acquired immune deficiency syndrome (AIDS) incidence, 14 breast cancer incidence, 15 homicide risk, 16 and excess mortality. 17 Research in perinatal health demonstrates modest but consistent effects of neighborhood-level socioeconomic disparities in key pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Development of a Standardized Neighborhood Deprivation Index

et al. 2006

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Census data are widely used for assessing neighborhood socioeconomic context. Research using census data has been inconsistent in variable choice and usually limited to single geographic areas. This paper seeks to a) outline a process for developing a neighborhood deprivation index using principal components analysis and b) demonstrate an example of its utility for identifying contextual variables that are associated with perinatal health outcomes across diverse geographic areas. Year 2000 U.S. Census and vital records birth data (1998)(1999)(2000)(2001) were merged at the census tract level for 19 cities (located in three states) and five suburban counties (located in three states), which were used to create eight study areas within four states. Census variables representing five socio-demographic domains previously associated with health outcomes, including income/poverty, education, employment, housing, and occupation, were empirically summarized using principal components analysis. The resulting first principal component, hereafter referred to as neighborhood deprivation, accounted for 51 to 73% of the total variability across eight study areas. Component loadings were consistent both within and across study areas (0.2-0.4), suggesting that each variable contributes approximately equally to Bdeprivation^across diverse geographies. The deprivation index was associated with the unadjusted prevalence of preterm birth and low birth weight for white non-Hispanic and to a lesser extent for black non-Hispanic women across the eight sites. The high correlations between census variables, the inherent multidimensionality of constructs like neighborhood deprivation, and the observed associations with birth outcomes suggest the utility of using a deprivation, index for research into neighborhood effects on adverse birth outcomes.

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“…Já as medicações (antidepressivos, ansiolíticos, anoréxicos, analgésicos), principalmente benzodiazepínicos (BDZ) e anfetamínicos, são de longe mais consumidas entre as mulheres (sem prescrição médica) (Galduróz et al, 2005) de todas as idades (Carlini et al, 2005 Embora não haja consenso sobre a relação entre o uso de substâncias psicoativas e as situações de violência vividas pelas mulheres, alguns estudos demonstram que as mulheres agredidas fazem uso como uma forma de lidar ou reagir às situações vividas (Grisso et al, 1999), algumas passam a utilizar especificamente anti-hipertensivos ou ansiolíticos (Ramos-Lira et al, 2001;Bonifaz e Nakano, 2004;Adeodato, 2005). Assim, o uso de substâncias psicoativas pela mulher agredida é interpretado como uma resposta ao estresse pós-traumático ocasionado pela própria vivência de situações violentas (Campbell, 2002) (Matos, 2000).…”

Section: Diferenças No Consumo De Drogas Entre Os Gênerosunclassified

“…Há outro dado relevante: o uso abusivo ou dependente de álcool e de drogas ilícitas é cada vez mais evidente entre as mulheres agredidas (Grisso et al, 1999;Tuten et al, 2004;Murphy et al, 2005;Galvani, 2006), sendo relacionado também ao aumento na probabilidade de vivência de situações de violência pelo parceiro íntimo e, até quando elas mesmas são as perpetradoras da violência (Lipsky et al, 2005).…”

Section: Introductionunclassified

Violência e uso de substâncias psicoativas: um estudo com mulheres usuárias de um serviço de Atenção Primária à Saúde de São Paulo

Silva¹

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Violent Injuries among Women in an Urban Area

Cited by 180 publications

References 27 publications

Domestic Abuse in the Emergency Department: Can a Risk Profile Be Defined?

Domestic Abuse in the Emergency Department: Can a Risk Profile Be Defined?

The Development of a Standardized Neighborhood Deprivation Index

Violência e uso de substâncias psicoativas: um estudo com mulheres usuárias de um serviço de Atenção Primária à Saúde de São Paulo

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