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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Impact of Intimate Partner Violence on Children's Well-Child Care and Medical Home
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Impact of Intimate Partner Violence on Children's Well-Child Care and Medical Home

机译:亲密伴侣暴力对儿童的托儿所和医疗之家的影响

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OBJECTIVES. Intimate partner violence has been linked to poor child health. A continuous relationship with a primary care pediatric provider can help to detect intimate partner violence and connect families with needed services. The objectives of this study were to determine the relationship between intimate partner violence and (1) maternal report of a regular site for well-child care, (2) maternal report of a primary pediatric provider, (3) well-child visits in the first year of life, (4) up-to-date immunizations at 2 years of age, (5) maternal report of medical neglect, and (6) maternal report of the pediatric provider–caregiver relationship.METHODS. This retrospective cohort study evaluated data from 209 at-risk families participating in the evaluation of the Healthy Families Alaska program. Research staff interviewed mothers near the time of an index child's birth and again at the child's second birthday. Medical charts were abstracted for information on well-child visits and immunizations.RESULTS. Mothers who disclosed intimate partner violence at the initial interview ( n = 62) were significantly less likely to report a regular site for well-child care or a primary pediatric provider. In multivariable models, children of mothers who disclosed intimate partner violence tended to be less likely to have the recommended 5 well-child visits within the first year of life and were significantly less likely to be fully immunized at 2 years of age. Differences in medical neglect were not statistically significant. Of mothers who reported a specific primary pediatric provider, those with intimate partner violence histories trusted this provider less and tended to rate less favorably pediatric provider–caregiver communication and the overall quality of the pediatric provider–caregiver relationship.CONCLUSIONS. Future research should explore effective ways to link intimate partner violence–exposed children with a medical home and a primary pediatric provider and to improve relationships between pediatric providers and caregivers who face violence at home.
机译:目标亲密伴侣的暴力行为与儿童健康不良有关。与初级保健儿科医师的持续关系可以帮助发现亲密伴侣的暴力行为,并为家庭提供所需的服务。这项研究的目的是确定亲密伴侣的暴力行为与(1)定期提供良好托儿服务的母亲报告,(2)初级儿童提供者的母亲报告,(3)亲子访视之间的关系。生命的第一年,(4)2岁时进行的最新免疫接种,(5)孕产妇医疗疏忽报告,以及(6)儿科提供者与照料者关系的孕产报告。这项回顾性队列研究评估了来自209个有风险的家庭的数据,这些家庭参加了阿拉斯加健康家庭计划的评估。研究人员在即将分娩的孩子出生时以及在孩子的第二个生日时再次采访了母亲。摘录了医疗图表以获取有关儿童就诊和免疫的信息。在初次访谈中发现亲密伴侣暴力的母亲(n = 62)显着较少报告定期接受良好儿童保育或初级儿科医生的场所。在多变量模型中,发现亲密伴侣暴力的母亲的孩子在出生后的第一年内往往不太可能接受推荐的5次健康儿童访视,并且在2岁时接受完全免疫的可能性也大大降低。医学上的忽视差异无统计学意义。在报告有具体的主要儿科医疗服务提供者的母亲中,具有亲密伴侣暴力史的母亲对这个提供者的信任度较低,并且往往对儿童提供者与护理人员的沟通以及儿童提供者与护理人员之间的关系的整体质量评分较低。未来的研究应探索将亲密伴侣暴力暴露的儿童与医疗之家和主要的儿科提供者联系起来的有效方法,并改善儿科提供者与在家中遭受暴力的看护者之间的关系。

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