Clinical Utility of an Intimate Partner Violence Screening Tool for Female VHA Patients

被引:63
作者
Iverson, Katherine M. [1 ,2 ]
King, Matthew W. [1 ]
Resick, Patricia A. [1 ,2 ,3 ]
Gerber, Megan R. [4 ,5 ]
Kimerling, Rachel [6 ,7 ]
Vogt, Dawne [1 ,2 ]
机构
[1] VA Boston Healthcare Syst, Womens Hlth Sci Div, Natl Ctr PTSD, Boston, MA 02130 USA
[2] Boston Univ, Sch Med, Dept Psychiat, Boston, MA 02118 USA
[3] Boston Univ, Dept Psychol, Boston, MA 02215 USA
[4] VA Boston Healthcare Syst, Womens Hlth, Boston, MA 02130 USA
[5] Boston Univ, Sch Med, Dept Gen Internal Med, Boston, MA 02118 USA
[6] VA Palo Alto Hlth Care Syst, Natl Ctr PTSD, Menlo Pk, CA USA
[7] VA Palo Alto Hlth Care Syst, Ctr Hlth Care Evaluat, Menlo Pk, CA USA
关键词
diagnostic accuracy; sensitivity and specificity; partner abuse; screening; women veterans; POSTTRAUMATIC-STRESS-DISORDER; DOMESTIC VIOLENCE; MENTAL-HEALTH; ABUSED WOMEN; VALIDITY; IMPACT;
D O I
10.1007/s11606-013-2534-x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Female Veterans are at high risk for physical, sexual, and psychological forms of intimate partner violence (IPV) victimization. This study evaluated the accuracy of a brief IPV victimization screening tool for use with female Veterans Health Administration (VHA) patients. Participants completed a paper-and-pencil mail survey that included the four-item Hurt/Insult/Threaten/Scream (HITS) and the 39-item Revised Conflict Tactics Scales (CTS-2). Operating characteristics, including sensitivity and specificity, were calculated using the CTS-2 as the reference standard for past-year IPV. Female veterans from a roster of randomly selected female patients of the New England VA Healthcare System. Women must have reported being in an intimate relationship in the past year to be included. Primary measures included the HITS (index test) and the CTS-2 (reference standard). This study included 160 women. The percentage of women who reported past-year IPV, as measured by any physical assault, sexual coercion, and/or severe psychological aggression on the CTS-2, was 28.8 %. The receiver-operator characteristic curve demonstrated that the HITS cutoff score of 6 maximizes the true positives while minimizing the false positives in this sample. The sensitivity of the optimal HITS cutoff score of 6 was 78 % (95 % CI 64 % to 88 %), specificity 80 % (95 % CI 71 % to 87 %), positive likelihood ratio 3.9 (95 % CI 2.61 to 5.76), negative likelihood ratio 0.27 (95 % CI 0.16 to 0.47), positive predictive value 0.61 (95 % CI 0.47, 0.73), and negative predictive value 0.90 (95 % CI 0.82, 0.95). For a low-burden screen, the HITS demonstrated good accuracy in detecting past-year IPV relative to the CTS-2 in a sample of female VHA patients with an optimal cutpoint of 6. The HITS may help VHA and other health-care providers detect past-year IPV and deliver appropriate care for female Veterans.
引用
收藏
页码:1288 / 1293
页数:6
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