Health professionals debate screening for intimate partner violence

Many doctors and hospitals have implemented procedures to screen women for intimate partner violence. The practice, however, is controversial. The U.S. Preventive Services Task Force makes no recommendation on screening because of a lack of evidence that it can do much good.

A study published today in the Journal of the American Medical Assn. concurs with that assessment. Researchers in Canada conducted a study at 11 emergency rooms, 12 family practices and three ob-gyn clinics in Ontario, Canada. The study involved 6,743 women age 18 to 64. Half the women completed an abuse screening tool. If the woman reported past abuse, that information was given to her clinician before the healthcare visit. The other group of women completed the same screening tool but after the healthcare visit. The women were surveyed over a period of 18 months about incidents of violence and quality of life.

The study found no difference in the two groups in incidents of violence, quality of life and use of violence-related health and social services.

"It is certainly understandable that clinicians and health care facilities have implemented universal screening programs, given the prevalence and potential severity of intimate partner violence," doctors from the University of North Carolina wrote in an editorial accompanying the study. "However, the results of this study ... should dispel any illusions that universal screening with passive referrals to community services is an adequate response to violence in intimate relationships."

Perhaps this idea should be tested: Officials at St. Joseph's Regional Medical Center and the Passaic County Courthouse in Passaic County, N.J., have launched a joint program that allows victims of intimate partner violence to obtain temporary restraining orders from a judge on the spot. The hospital staff simply connects victims to a judge via teleconferencing. The story is reported today in the Bergen Record.

-- Shari Roan

Photo: Dr. James Pruden, director of telemedicine at St. Joseph's Regional Medical Center, left, and state family court Judge Richard M. Freid, seen on the monitor, are seen in Paterson, N.J. Domestic violence victims will get treatment and can obtain temporary restraining orders at a New Jersey hospital. The emergency room at St. Joseph's Regional Medical Center is linked with the Passaic County Courthouse by video conference. Photo credit: Elizabeth Lara / The Bergen Record / AP photo

Comments

[Pearl]

Just women? They're ONLY screening women? Sexist pigs.

[anon]

Would it be more productive to video tape probate judges and have law students screen their performance for legal and moral quality and establish an improvement procedure such as three strikes and you're out of the law profession. I wonder how many children would benefit in terms of quality time with their parents.

[H Hilborn]

"Intimate Partner Violence" ?
Regular old "Domestic Violence" not good enough?
Looks like the We Can Change Reality By Changing Labels Brigade is at it again. They're the same ones who transformed the Illiterate into the Pre-Literate, implying that those folks are heading on down to school even as we speak. Illegal Aliens become Undocumented Migrants. I guess next they might be the Inconveniently Unpapered. Look out for the nomenclature changers - they're up up no good.

[D Davidov]

In response to H Hilborn's comment above - the term "Intimate Partner Violence" has been adopted instead of "Domestic Violence" because "domestic" violence implies that the violence can only occur in a "domestic setting", such as a home, or, for example, between two individuals who are married. Being as this violence can occur between two individuals who are dating, cohabitating, married, divorced, or have only been out on one date - the term "domestic violence" is very limiting. It leads to many misconceptions about violence between intimate partners. "Intimate Partner Violence" can also encompass violence between same-sex or heterosexual partners, while the term "domestic violence" does not usually bring these instances to mind.

Nomenclature and labels are extremely important in this type of research. If researchers do not define a situation as one that victims and/or participants of research do not understand or think applies to them - serious consequences can occur. Results of research can be severely biased by one simple definition. This is not to just be politically correct. Being "all-encompassing" is an extremely important concept in public health.

[J.Batista]

There is a need for screening for Intimate Partner Violence. As a previous blogger posted,IPV broadens the area of Domestic violence to even the online dater who meets an individual for the first time and there is an act of violence. We all must understand that IPV isn't always physical. Many times the victim is verbally or emotionally abused. The outcome of this abuse can lead to major health problems such as depression from low self esteem issues, obesity, heart disease, suicide, and several other health and social issues. As a nurse, I do screening on all of my patients with a very good outcome of my screening. Many times an individual will talk of past experiences of abuse (even child abuse) and ask for some type of interventional care, such as counseling. This is important because there is a connection between child abuse and those who are in abusive relationships as an adult, It is not the actual screening that gives the outcome of whether or not an individual will open up to you, but the way you ask the questions. Another reason that it is important to screen the patients, is because in many if not all of the states, those who were victims of any type of child abuse, can still press charges against the abuser even if he or she is 100 years old. As a reminder, 1 in 3 individuals in the room with you have experienced some type of child abuse; 1 in 5 individuals from that group have been or will be abused as adults. The screening is a vital tool whether it is a nurse or a doctor administering it.Oh yeah, for the one that wrote that the screening only applies to women, out of 6 million children abused every year, 12% are girls and 6% are boys that are sexually abused, and these are the reported incidences.