Table 3.
Survey Results Pre and Postintervention
| Preintervention | Post intervention | Difference | PValue | |
|---|---|---|---|---|
| Responsibility to assess for IPV* | ||||
| Primary care providers are asked to do increasingly more for patients in increasingly less time. For each of the statements below please mark your level of agreement regarding what should be expected of a primary care provider | ||||
| A primary care provider's responsibility includes: | ||||
| Screening female patients for DV at every routine health maintenance visit | 3.68 | 3.98 | 0.29 | .0003 |
| Asking all patients with chronic pain about the possibility of DV | 3.58 | 4.00 | 0.42 | <.0001 |
| Asking about DV any time an injury is noticed, regardless of the stated cause | 3.66 | 3.93 | 0.27 | .0008 |
| Asking about DV at every visit.# (Social desirability) | 2.47 | 2.85 | 0.37 | <.0001 |
| Responsibility to assess scale | 3.64 | 3.96 | 0.33 | <.0001 |
| Responsibility to counsel about IPV* | ||||
| A primary care provider's responsibility includes: | ||||
| Telling a patient that an abusive partner's behavior is not acceptable | 4.45 | 4.41 | −0.04 | .52 |
| Telling a patient that a particular relationship is harmful to his or her health | 4.09 | 4.15 | 0.05 | .35 |
| Following up with a patient after making a referral to a DV agency | 4.16 | 4.10 | 0.06 | .42 |
| Responsibility to counsel scale | 4.23 | 4.22 | −0.01 | .87 |
| Respect for patient autonomy† | ||||
| A primary care provider's responsibility includes: | ||||
| Making sure a patient gets to a shelter right away if he or she discloses abuse | 2.34 | 2.74 | 0.40 | <.0001 |
| Telling a patient he or she needs to leave an abusive relationship | 2.48 | 2.83 | 0.35 | <.0001 |
| Respect for autonomy scale | 2.41 | 2.78 | 0.36 | <.0001 |
| Empathy with patients' choices‡ | ||||
| Health care providers find it easier to empathize with some people's choices than others. Imagine your patient is choosing to remain in an abusive relationship. For each of the patient types listed below, please mark how easy or difficult it is for you to empathize with their decision to remain in the abusive relationship: | ||||
| An uneducated, low-income woman who is financially reliant on her partner | 3.41 | 3.61 | 0.20 | .04 |
| An educated middle-class mother of 2 | 2.92 | 3.16 | 0.24 | .02 |
| A single professional who has a thriving career | 2.43 | 2.73 | 0.30 | .01 |
| An educated gay male | 2.60 | 2.94 | 0.34 | .0007 |
| A woman with severe depression | 3.24 | 3.54 | 0.30 | .003 |
| A heterosexual married man with a steady income | 2.60 | 2.87 | 0.27 | .007 |
| A woman with severe physical disabilities | 3.42 | 3.61 | 0.19 | .07 |
| A man with severe physical disabilities | 3.38 | 3.62 | 0.24 | .02 |
| Empathy scale | 2.99 | 3.24 | 0.25 | .002 |
| Barriers† | ||||
| Primary care providers face numerous barriers when it comes to screening for and treating DV. Please mark your level of agreement with each of the following statements: | ||||
| I do not have enough time to ask about DV | 3.42 | 3.55 | 0.13 | .17 |
| I am afraid of offending the patient if I ask about DV | 3.38 | 3.54 | 0.15 | .10 |
| I find it difficult to get the patient alone if he or she is accompanied by a partner | 2.88 | 3.03 | 0.14 | .16 |
| I am afraid that a positive disclosure will take up too much of my time | 3.63 | 3.71 | 0.09 | .34 |
| I don't feel like I can help a patient who is in an abusive relationship | 4.05 | 4.04 | −0.01 | .94 |
| I feel patients who are being abused are unlikely to change their situation | 3.58 | 3.59 | 0.01 | .94 |
| I feel like I have wasted my time if I make an effort to help an abuse victim but he or she stays in the relationship | 4.02 | 4.01 | −0.01 | .93 |
| I don't have the resources to deal with a patient who discloses abuse | 3.77 | 4.03 | 0.26 | .01 |
| I have no place to refer patients who disclose abuse | 3.85 | 4.21 | 0.36 | .0004 |
| I am more interested in dealing with my patients' medical problems than their relationships | 3.88 | 3.90 | 0.01 | .86 |
| Barriers scale | 3.63 | 3.75 | 0.12 | .03 |
| Confidence§ | ||||
| If you interview patients, please indicate how confident you are in your ability to screen, diagnose, respond, refer, and document DV. If you do not interview patients please skip to the next section. | ||||
| Screen for DV | 1.92 | 2.35 | 0.43 | <.0001 |
| Diagnose abuse as a cause of other medical problems | 1.72 | 1.91 | 0.20 | .02 |
| Respond effectively to a patient who discloses that he or she is experiencing DV | 2.28 | 2.47 | 0.19 | .02 |
| Make appropriate referrals to DV agencies at my institution and in the community | 2.22 | 2.53 | 0.31 | .0004 |
| Provide documentation about DV in a patient's records | 2.22 | 2.40 | 0.18 | .04 |
| Confidence scale | 2.07 | 2.33 | 0.26 | <.0001 |
| Self-reported assessment behavior∥ | ||||
| Please indicate how often you have asked a patient about the possibility of DV when you saw any of the following conditions in the last month? If you have not seen this condition in the past month, mark N/A. Please skip to the next section if you do not interview patients. | ||||
| Injuries (bruises, lacerations, etc.) | 3.00 | 3.41 | 0.41 | .02 |
| Chronic pelvic pain | 2.34 | 2.91 | 0.57 | .008 |
| Irritable bowel syndrome | 2.04 | 2.47 | 0.43 | .02 |
| Headaches | 2.07 | 2.59 | 0.53 | .002 |
| Depression/anxiety | 2.71 | 3.26 | 0.55 | .002 |
| Coronary artery disease# (social desirability) | 1.59 | 2.05 | 0.46 | .02 |
| Routine health maintenance exam | 2.62 | 3.31 | 0.69 | .0009 |
| Prenatal care | 3.32 | 3.54 | 0.21 | .41 |
| Self-reported assessment behavior scale | 2.53 | 3.08 | 0.55 | .0001 |
| Knowledge¶ | ||||
| What question would you ask to screen for DV? | 0.48 | 0.83 | 0.35 | .0001 |
| List 4 reasons you may have an increased suspicion about the presence of DV | 1.92 | 2.29 | 0.37 | .002 |
| List 4 ways a batterer may control his or her partner | 2.08 | 2.57 | 0.49 | .001 |
| List 4 ways you can help a patient who has just disclosed to you that she is being abused | 1.91 | 2.36 | 0.45 | .0006 |
| List 4 pieces of information that should be documented in the medical records for a patient who is experiencing DV | 1.82 | 2.36 | 0.54 | .0002 |
| Knowledge scale | 1.64 | 2.08 | 0.44 | <.0001 |
*
Items are on a 5-point Likert scale: 1=strongly disagree to 5=strongly agree.
†
Items are reverse scored on a 5-point Likert scale: 1=strongly agree to 5=strongly disagree.
‡
Items are on a 5-point Likert scale: 1=very difficult to 5=very easy.
§
Items are on a 3-point Likert scale: 1=not confident to 3=very confident.
¶
Items are scored from 0 to 4.
∥
Items are on a 5-point Likert scale: 1=never to 5=always.
#
Social desirability items are not included in summary scores
Summary scores for each scale are scored by summing the items and dividing by the number of items answered. DV, domestic violence.