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Abstract
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Injury is the leading cause of death for Americans from infancy to middle age. Thirty-seven per cent of injuries admitted to this faculty are the result of personal violence. A prospective pilot study sought to elucidate the circumstances of such injuries. Medical records of all admissions for gunshot wounds, stab wounds or assault during a 30-day period were reviewed (N = 105). A subset (N = 32) were interviewed and given psychometric tests. Distribution by mode of injury was assault, 46 per cent; stabbing, 42 per cent; shooting, 12 per cent. Single, black males aged 18-44 dominated the sample. Injuries tended to occur in or near bars (82 per cent), between 1800 and 0600 hours (79 per cent) and were accompanied by alcoholic intoxication (63 per cent). Un- or underemployment was prevalent (56 per cent). Thirty-eight per cent of incomes were below the official poverty level. Some victims were illiterate. Histories of previous violent encounters (mean number = 22) during the year before the injury and hospital treatment for previous injury were common (56 per cent). Those interviewed reported high frequencies of recent and developmental stresses. The yearly cost of the acute care of patients with injuries caused by violence and treated at this hospital is estimated to be $8,000,000. Of this 80 per cent is paid for with public funds. Personal violence is a serious but neglected part of public health.
VioLit summary:
OBJECTIVE:
This study by Sumner et al. examined characteristics of persons sustaining injuries which resulted in hospitalization and which were caused by personal violence. A public health approach to research and practice in personal violence was advocated.
METHODOLOGY:
An exploratory, non-experimental research design was employed in this pilot study. All patients who were treated in the Emergency Department of a San Francisco hospital for gunshot wounds, stab wounds, and injuries resulting from assault during a 30-day period in 1984; out of 105 patients, 32 were selected for the study. Excluded groups were patients not admitted to the hospital, those with language barriers, self-inflicted injuries, and those admitted to the psychiatric or forensic units of the hospital. Patients were interviewed in both structured and unstructured ways. Steadman's protocol for the study of situational factors in violence was used as a starting point. Gough's Adjective checklist was included as were other topics regarding stress in employment, finance, health, relationships, legal and housing situations. Response format was designed for persons with no psychiatric training.
FINDINGS/DISCUSSION:
Distribution by mode of injury was assault, 46%; stabbing, 42%; shooting, 12%. Single, black males aged 18-44 dominated the sample. Injuries tended to occur in or near bars (82%), between 6 PM and 6 AM (79%), and were accompanied by alcoholic intoxication (63%). 56% were un-or underemployed, and 38% of incomes were below the poverty level. Mean number of previous violent encounters during the year before the injury was 22. Hospital treatment for previous injury was common (56%). Those interviewed reported high frequencies of recent and developmental stresses.
AUTHORS' RECOMMENDATIONS:
The authors concluded that violent injury is a serious matter in public health and mental health and that effective intervention programs will require more understanding of the subject, particularly in the areas of alcohol and drug involvement in these injuries. The assessment of those at risk and subsequent referral should begin in emergency and hospital inpatient departments. Facilities should be broad-based and multifaceted, focusing on strengthening problem solving skills and other social-psychological abilities. Instruction was also advocated as was reshaping media presentation of violence and minority males.
EVALUATION:
This study met its goals as a pilot study. We are given a picture of who is more likely to be victimized by violence and, in concert with past findings, the poor and minorities are in more danger and are more likely to be shut off from the help they really need. There were some conclusions that were not backed up with the means they used to assess them. For example, "Ten percent appeared to be related to drugs" (259). It is not clear how this and some other assessments were reached. However, this work is only the beginning of what will be sure to be greatly needed information about violent victimization. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
KW - California
KW - Public Health
KW - Injury
KW - Alcohol Use Effects
KW - Drug Use Effects
KW - At Risk
KW - Violence Intervention
KW - Intervention Recommendations
KW - Victimization Effects
KW - Victimization Causes
KW - Violence Causes
KW - Violence Effects
KW - Adult Victim
KW - Adult Violence
KW - Juvenile Victim
KW - Juvenile Violence
KW - Hospital
KW - Emergency Room |