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Screening for Intimate Partner Violence

by Catherine Coleman, editor-in-chief for ProCor.

Clinical screening of women for abuse, and appropriate responses to their needs, is essential to promote women's health and well-being, and is regarded as a good public health preventive strategy. "Intimate partner violence" offers a useful summary of suggestions for effective screening, and may be helpful in developing locally appropriate preventive strategies.
       Title: Intimate partner violence
       Author: AS Gotlieb
       Reference: Journal Watch: Women's Health, 2 Oct 2008 (open access)

Below is a summary of the article.

Intimate partner violence (IPV) describes a pattern of behaviors (such as beating, injury, psychological abuse, sexual assault, social isolation, and intimidation) by someone who is or was involved in an intimate relationship with the victim. Women who have been abused experience higher rates of health issues, including cardiovascular problems, and in some situations may be more likely to seek medical care. Medical visits offer clinicians an opportunity to identify and counsel women who have experienced violence.

Suggestions for effective screening include:

  • Use a setting that is as safe and private as possible.
  • No adult known to the patient should be present.
  • Older children should leave room before any questions are asked.
  • Begin with a general statement affirming that many women have experienced violence.
  • Ask if the patient feels safe in her relationship.
  • Ask specifically about behaviors like hitting, pushing, choking, forced sexual intercourse.
  • Avoid vague terms like "physical abuse" or "sexual abuse."
  • If you suspect abuse, tell the patient gently and non-judgmentally that you are concerned.
  • At subsequent visits, address abuse as part of the patient's health issues.

When a patient reveals that she is being abused:

  • Validate her experience by telling her that she is not alone and that no one deserves to be hurt.
  • Ask whether the abuser has a weapon or has ever threatened to kill the patient.
  • Ask whether the patient feels that she is in any immediate danger.
  • Ask about specific types of abuse and whether the patient has ever sought medical treatment or has ever attempted suicide.
  • Provide the patient with information about available resources.
  • Help the patient develop a "quick-escape" plan in case she needs to flee quickly (identify places she can go if she is in danger; make copies of important personal and family documents; pack essential clothing; store papers and clothing outside the home).

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