Abstract
Objectives: To identify the prevalence of domestic violence (DV) (defined as physical abuse perpetrated by intimate partners) in women attending an inner city accident and emergency department and to elicit women's response about being asked routinely about domestic violence in this setting.
Methods: 22 nursing shifts were purposefully sampled to be representative of day, night, and weekends. A questionnaire was administered to 198 consenting women who were not intoxicated, confused, or critically ill.
Results: The prevalence of acute trauma in women attributable to DV was 1% (95%CI 0.14 to 3.6), the prevalence of lifetime physical abuse was 34.8% (95%CI 28.2 to 41.5), of past year physical abuse was 6.1% (95%CI 3.2 to 10.3), and of lifetime life threatening physical abuse was 10.6% (95%CI 6.3 to 14.9). Seventy six per cent of women felt comfortable about being asked about DV and 60.5% of women felt that they should always or usually be asked about DV in this setting.
Conclusion: This cross sectional survey adds to the body of knowledge showing that the prevalence of DV in women attending an accident and emergency department is high. Most women were in favour of being asked, and disclosure was associated with discomfort in few women. This sensitive area of history taking and referral could be undertaken by health professionals using a supportive approach.
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Selected References
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- Barry C. A., Bradley C. P., Britten N., Stevenson F. A., Barber N. Patients' unvoiced agendas in general practice consultations: qualitative study. BMJ. 2000 May 6;320(7244):1246–1250. doi: 10.1136/bmj.320.7244.1246. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bergman B., Brismar B., Nordin C. Utilisation of medical care by abused women. BMJ. 1992 Jul 4;305(6844):27–28. doi: 10.1136/bmj.305.6844.27. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bradley Fiona, Smith Mary, Long Jean, O'Dowd Tom. Reported frequency of domestic violence: cross sectional survey of women attending general practice. BMJ. 2002 Feb 2;324(7332):271–271. doi: 10.1136/bmj.324.7332.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Campbell Jacquelyn C. Health consequences of intimate partner violence. Lancet. 2002 Apr 13;359(9314):1331–1336. doi: 10.1016/S0140-6736(02)08336-8. [DOI] [PubMed] [Google Scholar]
- Caralis P. V., Musialowski R. Women's experiences with domestic violence and their attitudes and expectations regarding medical care of abuse victims. South Med J. 1997 Nov;90(11):1075–1080. doi: 10.1097/00007611-199711000-00003. [DOI] [PubMed] [Google Scholar]
- Coid J., Petruckevitch A., Feder G., Chung W., Richardson J., Moorey S. Relation between childhood sexual and physical abuse and risk of revictimisation in women: a cross-sectional survey. Lancet. 2001 Aug 11;358(9280):450–454. doi: 10.1016/s0140-6736(01)05622-7. [DOI] [PubMed] [Google Scholar]
- Dearwater S. R., Coben J. H., Campbell J. C., Nah G., Glass N., McLoughlin E., Bekemeier B. Prevalence of intimate partner abuse in women treated at community hospital emergency departments. JAMA. 1998 Aug 5;280(5):433–438. doi: 10.1001/jama.280.5.433. [DOI] [PubMed] [Google Scholar]
- Eisenstat S. A., Bancroft L. Domestic violence. N Engl J Med. 1999 Sep 16;341(12):886–892. doi: 10.1056/NEJM199909163411206. [DOI] [PubMed] [Google Scholar]
- Ellsberg Mary, Heise Lori. Bearing witness: ethics in domestic violence research. Lancet. 2002 May 4;359(9317):1599–1604. doi: 10.1016/S0140-6736(02)08521-5. [DOI] [PubMed] [Google Scholar]
- Fanslow J. L., Norton R. N., Robinson E. M., Spinola C. G. Outcome evaluation of an emergency department protocol of care on partner abuse. Aust N Z J Public Health. 1998 Aug;22(5):598–603. doi: 10.1111/j.1467-842x.1998.tb01445.x. [DOI] [PubMed] [Google Scholar]
- Foy R., Nelson F., Penney G., McIlwaine G. Antenatal detection of domestic violence. Lancet. 2000 May 27;355(9218):1915–1915. doi: 10.1016/s0140-6736(05)73366-3. [DOI] [PubMed] [Google Scholar]
- Friedman L. S., Samet J. H., Roberts M. S., Hudlin M., Hans P. Inquiry about victimization experiences. A survey of patient preferences and physician practices. Arch Intern Med. 1992 Jun;152(6):1186–1190. doi: 10.1001/archinte.152.6.1186. [DOI] [PubMed] [Google Scholar]
- García-Moreno C. Dilemmas and opportunities for an appropriate health-service response to violence against women. Lancet. 2002 Apr 27;359(9316):1509–1514. doi: 10.1016/S0140-6736(02)08417-9. [DOI] [PubMed] [Google Scholar]
- Goldberg W. G., Tomlanovich M. C. Domestic violence victims in the emergency department. New findings. JAMA. 1984 Jun 22;251(24):3259–3264. [PubMed] [Google Scholar]
- Howe A., Crilly M., Fairhurst R. Acceptability of asking patients about violence in accident and emergency. Emerg Med J. 2002 Mar;19(2):138–140. doi: 10.1136/emj.19.2.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jewkes Rachel. Preventing domestic violence. BMJ. 2002 Feb 2;324(7332):253–254. doi: 10.1136/bmj.324.7332.253. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCauley J., Yurk R. A., Jenckes M. W., Ford D. E. Inside "Pandora's box": abused women's experiences with clinicians and health services. J Gen Intern Med. 1998 Aug;13(8):549–555. doi: 10.1046/j.1525-1497.1998.00166.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McFarlane J., Parker B., Soeken K., Bullock L. Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care. JAMA. 1992 Jun 17;267(23):3176–3178. doi: 10.1001/jama.267.23.3176. [DOI] [PubMed] [Google Scholar]
- McLeer S. V., Anwar R. A study of battered women presenting in an emergency department. Am J Public Health. 1989 Jan;79(1):65–66. doi: 10.2105/ajph.79.1.65. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McNutt L. A., Carlson B. E., Gagen D., Winterbauer N. Reproductive violence screening in primary care: perspectives and experiences of patients and battered women. J Am Med Womens Assoc. 1999 Spring;54(2):85–90. [PubMed] [Google Scholar]
- Norton L. B., Peipert J. F., Zierler S., Lima B., Hume L. Battering in pregnancy: an assessment of two screening methods. Obstet Gynecol. 1995 Mar;85(3):321–325. doi: 10.1016/0029-7844(94)00429-H. [DOI] [PubMed] [Google Scholar]
- Petersen R., Gazmararian J. A., Spitz A. M., Rowley D. L., Goodwin M. M., Saltzman L. E., Marks J. S. Violence and adverse pregnancy outcomes: a review of the literature and directions for future research. Am J Prev Med. 1997 Sep-Oct;13(5):366–373. [PubMed] [Google Scholar]
- Ramsay Jean, Richardson Jo, Carter Yvonne H., Davidson Leslie L., Feder Gene. Should health professionals screen women for domestic violence? Systematic review. BMJ. 2002 Aug 10;325(7359):314–314. doi: 10.1136/bmj.325.7359.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Richardson J., Feder G., Eldridge S., Chung W. S., Coid J., Moorey S. Women who experience domestic violence and women survivors of childhood sexual abuse: a survey of health professionals' attitudes and clinical practice. Br J Gen Pract. 2001 Jun;51(467):468–470. [PMC free article] [PubMed] [Google Scholar]
- Richardson Jo, Coid Jeremy, Petruckevitch Ann, Chung Wai Shan, Moorey Stirling, Feder Gene. Identifying domestic violence: cross sectional study in primary care. BMJ. 2002 Feb 2;324(7332):274–274. doi: 10.1136/bmj.324.7332.274. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roberts G. L., Lawrence J. M., O'Toole B. I., Raphael B. Domestic violence in the Emergency Department: I. Two case-control studies of victims. Gen Hosp Psychiatry. 1997 Jan;19(1):5–11. doi: 10.1016/s0163-8343(96)00119-3. [DOI] [PubMed] [Google Scholar]
- Sethi D., Watts S., Watson J., McCarthy C., Zwi A. Experience of 'screening' for domestic violence in women's services. J Public Health Med. 2001 Dec;23(4):349–350. doi: 10.1093/pubmed/23.4.349. [DOI] [PubMed] [Google Scholar]
- Smith S., Baker D., Buchan A., Bodiwala G. Adult domestic violence. Health Trends. 1992;24(3):97–99. [PubMed] [Google Scholar]
- Spedding R. L., McWilliams M., McNicholl B. P., Dearden C. H. Markers for domestic violence in women. J Accid Emerg Med. 1999 Nov;16(6):400–402. doi: 10.1136/emj.16.6.400. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stammers T. Domestic violence: a hidden problem in general practice. Br J Gen Pract. 1996 Oct;46(411):623–624. [PMC free article] [PubMed] [Google Scholar]
- Venis Sarah, Horton Richard. Violence against women: a global burden. Lancet. 2002 Apr 6;359(9313):1172–1172. doi: 10.1016/S0140-6736(02)08251-X. [DOI] [PubMed] [Google Scholar]