ABSTRACT
BACKGROUND: Torture survivors typically present with varied and complex symptoms, which may challenge assessment by general practitioners (GPs). This study explored the prevalence of torture and trauma history among immigrants born in non-Western countries presenting to GPs in Denmark and the extent to which GPs ask this population about torture or trauma history. METHODS: Based on a self-reported questionnaire among non-western immigrant patients, we used bivariate analyses to determine the prevalence of torture and trauma history and the proportion of patients being asked by their GP about this. Data were analysed using multivariate logistic regression. RESULTS: From 46 GP clinics, 300 questionnaires were finalized by immigrant patients. Twenty-eight percent of the patients had a history of torture. Of these, significantly more were men (70%) than women (29%). About half of the torture survivors (55%) had been asked by their GP about torture history. The odds ratio (OR, 95% confidence interval) for being asked about torture history by the GP was 1.28 (0.46-3.53) among women compared with men. Compared with Southeast Europe, OR for being a torture survivor among male immigrants from Middle East-North African region and South and East Asia was 1.83 (0.81-4.15) and 0.25 (0.08-0.82), respectively. CONCLUSIONS: Our results suggest that torture and trauma are widespread among immigrants presenting to GPs. In our study, the GPs had managed to detect half of the torture survivors. A more systematic approach to detection in General Practice is advisable, and more knowledge on how and when to ask is needed.
Subject(s)
Emigrants and Immigrants , General Practitioners , Torture , Denmark/epidemiology , Europe , Female , Humans , Male , Middle East , Prevalence , Primary Health CareSubject(s)
Breast Neoplasms/mortality , Female , Humans , Mass Screening , Middle Aged , United KingdomABSTRACT
It is now documented that intensive care units do consider whether treatments promote "the good" and serve patients best. Uncritical use of technology to prolong the dying process must be avoided, and palliative principles worked out. Decisions to withhold or withdraw treatment are among the toughest for both patients and physicians. Legislation covering the area is sufficient, both with regard to competent as well as incompetent patients. However, there are major differences as to how the law is acted upon. Guidelines for futile intensive care treatment should therefore be worked out, and uncritical referral of patients to the ICU avoided.
