Docs May Ask About Domestic Violence

Intimate partner violence screenings to be done by gynecologists and obstetricians

(RxWiki News) Don't be surprised if the gynecologist asks a few personal questions or hands out a survey about relationship dynamics at home. Putting out feelers for domestic violence is part of their job.

After reviewing numerous studies on intimate partner violence screening tools, the US Preventive Services Task Force released a recommendation for healthcare professionals to screen and intervene in cases of intimate partner violence. No negative outcomes were reported due to the screening process or intimate partner violence interventions.

"Tell a healthcare professional if you experience domestic violence."

The US Preventive Services Task Force (USPSTF) has released an update to their 2004 recommendation on screening elderly and vulnerable (physically or mentally dysfunctional) adults for abuse, neglect and intimate partner violence. The recommendation is meant to guide healthcare professionals to spot abuse in those without obvious signs of abuse.

Background information given with the update reported nearly 31 percent of women and 26 percent of men claim to have experienced some form of intimate partner violence in their lifetime.

To update the recommendation, researchers reviewed 15 studies from the US, UK and Canada that used 13 screening instruments.

Risks for intimate partner violence include: injury, death, sexually transmitted disease, pelvic inflammatory disease and unintended pregnancy. Chronic pain, neurological disorders, gastrointestinal disorders, migraine headaches, mental health conditions and other disabilities have also been reported by people who have experienced intimate partner violence.

Six different screening tests were used in healthcare settings to spot different types of abuse, including physical violence, humiliation, threats, insults, sexual assault and trauma.

Based on results of the screening tests, healthcare professionals were then advised to intervene with a variety of options. Interventions included counseling, home visits, information cards, referrals to community services and mentoring.

Based on positive results found in past studies, the researchers recommended more computer-based screening. Patient feedback suggested women felt more comfortable with computer screening than with direct questions.

The USPSTF concluded that healthcare professionals should screen for intimate partner violence in women of childbearing age (14 to 46 years of age) and refer women who screen positive to intervention services.

The USPSTF also concluded there was not enough evidence on women older than childbearing age, the elderly and vulnerable adult abuse and neglect to determine the benefits or harms of screening.

No adverse effects were found from intimate partner violence screening.

The USPSTF recommended that healthcare professionals in female reproductive healthcare fields should screen for intimate partner violence at routine obstetric/gynecology, family planning, preconception and prenatal visits, and provide contact with an intervention service if necessary. 

This study was published in January in the Annals of Internal Medicine

No funding information was provided. No conflicts of interest were reported.

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Review Date: 
January 17, 2013