| 摘要: | 研究背景
自2009年聯合國宣布婦女平權、減少婦女受暴為千禧年(2009-2015)第三大目標後，世界各國針對家庭暴力親密伴侶暴力的研究及議題越來越重視，親密伴侶暴力所衍生的問題不僅僅是身體上的傷害，還包含心理方面的疾病及壓力，而且對家中其他成員目睹暴力事件也可能產生相當的影響。國外針對親密伴侶暴力之相關因素進行研究發現，施暴者若有使用酒精、藥物等較易產生暴力行為；針對種族部分美國及加拿大進行的研究，不同種族產生家庭暴力的機會也不同；針對文化差異的研究則發現，在男尊女卑的文化當中也較易產生家庭暴力；精神方面疾病也是相關危險因子；懷孕中的婦女也是被家暴的高危險群，綜觀目前大多數研究，針對施暴者的基本資料及相關特徵進行的研究較多，受暴者部份的研究則相對較少；對於家暴事件中可能會影響暴力發生的危險因子的研究比起其他研究相對更少。
家暴是否會重複發生也是大家重視的議題，研究發現暴力發生頻率及受傷嚴重程度與再返診有相關性。有研究提及受傷嚴重程度及受傷頻率是預測再家暴的危險因子，但所謂受傷嚴重程度到什麼程度比較容易再返診或是多久頻率發生一次家暴會是再家暴高危險群卻很難定義。針對受傷嚴重程度除了目前全世界常用的創傷嚴重程度評分(ISS)之外，若未使用客觀評分方式則嚴重程度皆有可能變成主觀評估，而不是客觀評估標準；而發生頻率部分則更難以正確統計，當病人發生暴力卻不是返回同一家醫院或到醫院就診表示受傷不是因為家庭暴力或者是有發生暴力事件但未就醫，所以使用發生頻率用以評估是否會因家暴再返診是更有難度的。
本研究針對親密伴侶事件中受暴及施暴者的基本資料進行分析希望找出親密伴侶暴力事件中相關危險因子；再針對因親密伴侶暴力再返診的病人尋找相關特徵。
對象及方法
本研究為病歷資料收集，收集102年1月1日到102年12月31日中，到雙和醫院就醫且自訴為遭受家庭暴力的所有病人。請病人填寫家暴通報單，我們收集病人當次家暴通報單上相關資料。加害人及被害人資料包括:性別、年齡、教育程度、工作類型、受暴時間、此次是否使用藥物或酒精；被害人收集受傷程度(包含挫傷、擦傷、骨折或單純主訴疼痛)，並收集受傷部位：頭頸部、軀幹、四肢，返診部份則追蹤病人家暴當日後一年內，因1.因家暴返急診2.因其他疾病返回急門診3.因家暴後遺症返門急診。從自述家暴來急診的病人資料中，收集兩造關係為婚姻中、分居、離婚、同居等關係，非上述關係則不納入。收集上述資料再使用chi-square及邏輯氏迴歸進行分析找出相關危險因子。
研究結果
本研究中，親密伴侶暴力共計402件。根據基本資料統整：女性受暴占87.56%，婚姻關係中發生暴力占68.41%。受暴者相關基本資料：年齡以31-40歲為最多(39.80%)，教育程度以高中職為主(37.07%)、大專占28.11%，種族則以本國非原住民最多(82.09%)；施暴者相關基本資料年齡以31-40歲為最多(25.37%)教育程度以高中職為主(28.61%)、種族則以本國非原住民最多(74.88%)。
因家暴再返本院就診有51件，其中受暴女性居多占86.28%(44位)，年齡以31-40歲為主占41.18%(21位)，但再返診族群中施暴年齡則以41-50歲(13人)為多占25.49%，教育程度及種族與親密伴侶暴力所有案件比較無特別不同而且兩造關係也都多為婚姻狀態中。
因家暴後遺症返診有34件，受暴族群一樣以婚姻狀態中為主，女性居多有31位，年齡以31-40歲9人為最多。而因家暴多次返診共16件，婚姻關係中為最多，當中女性有15位，年齡層31-40歲有6位(40%)，41-50歲有5位(31.25%)。再返診者中，受暴者教育程度與施暴者不同，其中在大專部分受暴者1人施暴者4人。其他族群受暴者與施暴者的教育程度人數分布差不多。
針對受傷相關因素，將因家暴返診族群與未返診族群互相比較後，無顯著差異，當使用邏輯式迴歸分析(logistic regression analysis)家暴再返診族群當中以年齡差、教育程度差、種族、婚姻狀況、工作狀況做為影響返診的危險因子。分析後發現，本國籍再返診勝算是非本國籍的0.263倍；受暴者與施暴者在婚姻中，返診勝算是非婚姻關係中的3.345倍，也就是說婚姻中再返診勝算比比較高。
Background
In 2009, the United Nations announced that the third targets in Millennium were about human rights of women and to reduce violence against women. Since 2009, these issues become more and more important worldwide. One of violence against women is intimate partner violence (IPV) with 35% prevalence. IPV can result in physical and mental problems as well as psychological impacts in family members.
There were several factors associated with domestic violence, alcohol or drugs, race, psychological problem, culture, and pregnancy. The studies of domestic violence in United States and Canada found that the race was an important risk factor. Overall, most present studies focused on the characteristics of abusers. However, the characteristics of victims need to be addressed carefully. Also, the study in the risk factor of domestic violence needs to be done.
Another important issue is re-victimization. The injury severity and frequency of violence were found to be associated with re-victimization. However, there is still no guideline in severity and frequency of injury for re-victimization. The most commonly instrument to assess the severity of injury is ISS (Injury Severity Score), but most of IPV were not evaluated their corresponding injury severity by ISS. In addition, some victims went to the same hospital but some were not, because of the geographic locations of hospitals in Taiwan. Therefore, the frequency of injury caused by IPV is hard to count and it would be not a good index for evaluating re-victimization.
In this study, the goals are to find the risk factor between abuser and victims for the intimate partner violence events, and to find out he related features of the re-victimization group.
Methods
This study collected medical records of the patients who came to Shang-Ho hospital from January 1th to December 31th in 2013, and they reported about domestic violence by themselves. We collected the abusers’ and victims’ data as following: age, gender, education level, marriage status, types of work, time of domestic violence, alcohol and drugs. We also collected victims’ injury severity (contusion, abrasion, fracture, complaint pain), and body location of injury (head and neck, trunk, limbs). The definition of re-victimization we had was these domestic violence patients revisited out hospital during 2013.01 – 2014.12. The number of returns and the reasons of returns were calculated. The returning reasons were classified into three categories: 1. intimate partner violence, 2. chronic disease, 3. intimate partner violence sequels. The factor, marriage status between abusers and victims, included marriage, separated, divorce, and cohabit. Other than the above relationships were excluded from this study. For analysis the risk factors of IPV, Chi-square and Logistic regression analysis were used.
Results
In this study, there were 402 IPV. Female Victims were 87.56%, and in marriage status 68.41%. Most victims aged 31-40years (39.80%), and most of victims had senior high school education (37.07%). Most of victims were Taiwan citizens and non-aboriginal (82.09%). Most abusers aged 31-40 years (25.37%) and had senior high school education level (28.61%). Most of abusers were Taiwan citizens and non-aboriginal (74.88%).
There were 51 victims who returned to hospital and caused byIPV. Female victims were 86.28% (44 people) and 41.18% of Victims aged 31-40 years (21 people). Most of corresponding abusers aged 41-50 years ( 25.49%). Victims and abuser had the same distribution in education level and race.
There were 34 victims who returned to hospital caused by IPV sequels, and most of them were in marriage status. Female of victims were 31 persons and most of them aged 31-40years (9 people). There were 16 people who returned to hospital more than twice caused by intimate partner violence, and most of them were in marriage status. There were 15 victims of female, and 6 persons aged 31-40years (40%) as well as 5 persons aged 41-50 years (31.25%). In this group, the numbers of people had college education were different between abusers and victims,( victims, 1 person and abuser, 4 persons). The distribution of education level was not different between abusers and victims who returned to hospital.
Comparing victims who returned or did not return to hospital, the risk factors were not significant. When using a logistic regression analysis, we found the odds of re-victimization for the citizenship was 0.263 times for non-citizenship. The odds of re-victimization for the victims in marriage was 3.345 times for victims in non-marriage status. |
