Qualität der Befunddokumentation und weiterführenden Betreuung von Gewaltopfern am Beispiel einer unfallchirurgischen Notaufnahme einer Großstadt

Abstract

People who have become victims of violence have manifold problems. Besides medical diagnostics and therapy, it is necessary to recognise the situation in which these patients have become such victims, to document the consequences of this violence for use in court and to offer further assistance. Victims of violence often contact primarily a trauma ambulance. The optimisation of the medical treatment of the victims is a relevant traumatological topic, which so far has received only very scant attention. Therefore the aim of this study was to evaluate the necessity for an interdisciplinary combination of treatments for the targeted treatment of these victims. Using a standardised data card a retrospective data analysis of all out-patients and all in-patients of a trauma centre with regard to the existence of a violent context was carried out for the year 2004. All such cases were included and the data were evaluated descriptively according to age, gender, information about the act of violence, consequences thereof, type and scope of the diagnostic findings, as well as inducements for further measures. In this context we differentiated between "domestic violence" and "public violence". The data of 7132 patients were evaluated. Altogether 347 victims of violence were identified (among them 109 victims of "public violence", 59 victims of domestic violence, and 179 cases that could not be allocated clearly). This results in a quota of 4.9% of all patients treated. The average age of the victims was 30.6 years. It was striking that in many cases the anamnesis and documentation were rather fragmentary. A very high percentage of victims of violence could be found among the patients needing traumatological treatment. With regard to the fragmentary care there is an enormous need for medical training and interdisciplinary treatment of victims of violence.