Study Compares Methods for Detecting Domestic Violence in Healthcare Settings
Domestic violence is a major public health problem. Unfortunately, only a fraction of its victims get the help they need, since domestically abused women are often reluctant to report an incident on their own. Studies have shown that women are more likely to disclose experiences of domestic violence in response to screening in a healthcare setting. But few studies have investigated which screening methods are most effective.
A new study in the August 2, 2006 issue of the Journal of the American Medical Association compared domestic violence screening of women using a computer, a written questionnaire, or a face-to-face interview in healthcare settings. The researchers found that women least preferred the face-to-face interview, and the written questionnaires elicited the most complete responses.
About the Study
This study included 2,461 women in Ontario, Canada who were ages 18-64. The women had appointments at one of six healthcare settings (eg, emergency departments, health clinics). The researchers randomly assigned the women to undergo screening for domestic violence by an intimate partner (eg, husband, ex-husband, boyfriend, ex-boyfriend) via one of three methods: a computer-based self-completed questionnaire, a written self-completed questionnaire, or a face-to-face interview by a physician or nurse.
There was no difference in the reported prevalence of domestic violence among the different methods of screening. When asked about the ease of responding, whether they liked the screening technique, and whether the screening was private enough, the women indicated that the face-to-face method was least preferred. The written questionnaire resulted in the most complete amount of information than the other methods.
These findings are limited because the women who were given the computerized or written screenings were told their healthcare professional would not be informed of their responses, but the face-to-face interviews were administered by a healthcare professional. This may have affected the participants’ willingness to disclose information and/or their preference for a screening method.
How Does This Affect You?
These findings bring to light an important issue for healthcare providers. To screen their patients for domestic violence, healthcare providers may want to consider using written questionnaires, which were preferred by the women in this study and yielded the most complete data. The screening instruments used in this study included questions about physical abuse, feelings of safety, and tension or arguments in the women’s relationships.
Since very few people identify themselves as victims of domestic violence, there is a pressing need to improve detection methods. By becoming familiar with domestic violence signs and with effective screening methods, healthcare professionals can help break the cycle of domestic abuse. If you or someone you know is being abused, talk to your physician or call the National Domestic Violence Hotline (1-800-799-SAFE).
National Center for Injury Prevention and Control
National Domestic Violence Hotline
1-800-799-SAFE, 1-800-799-3224 (TTY)
The National Women’s Health Information Center
Office of Violence Against Women
Department of Justice
Domestic violence. American College of Emergency Physicians website. Available at: http://www.acep.org/webportal/PatientsConsumers/HealthSubjectsByTopic/Violence/FactSheetDomesticViolence.htm . Accessed August 1, 2006.
MacMillan HL, Sathen CN, Jamieson E, et al. Approaches to screening for intimate partner violence in healthcare settings: a randomized trial. JAMA . 2006;296(5):530-536.
Multidisciplinary responses to domestic violence. American Bar Association website. Available at: http://www.abanet.org/domviol/mrdv/identify.html . Accessed August 1, 2006.
Last reviewed August 2006 by ]]>Richard Glickman-Simon, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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