Prevalence of Intimate Partner Abuse in Women Treated at Community Hospital Emergency Departments

Abstract

Context.-The majority of prior studies examining intimate partner abuse in the emergency department (ED) setting have been conducted in large, urban tertiary care settings and may not reflect the experiences of women seen at community hospital EDs, which treat the majority of ED patients in the United States. Objective.-To determine the prevalence of intimate partner abuse among female patients presenting for treatment in community hospital EDs and describe their characteristics. Design.-An anonymous survey conducted from 1995 through 1997 inquiring about physical, sexual, and emotional abuse. Setting.-Eleven community EDs in Pennsylvania and California. Participants.-All women aged 18 years or older who came to the ED during selected shifts. Main Outcome Measures.-Reported acute trauma from abuse, past-year physical or sexual abuse, and lifetime physical or emotional abuse. Results.-Surveys were completed by 3455 (74%) of 4641 women seen. The prevalence of reported abuse by an intimate partner was 2.2% (95% confidence interval [CI], 1.7%-2.7%) for acute trauma from abuse, 14.4% (95% CI, 13.2%-15.6%) for past-year physical or sexual abuse, and 36.9% (95% CI, 35.3%-38.6%) for lifetime emotional or physical abuse. California had significantly higher reported rates of past-year physical or sexual abuse (17% vs 12%, PϽ.001) and lifetime abuse (44% vs 31%, PϽ.001) than Pennsylvania. Logistic regression modeling identified 4 risk factors for reported physical, sexual, or acute trauma from abuse within the past year: age, 18 to 39 years (odds ratio [OR], 2.2; 95% CI, 1.7-3.0); monthly income less than $1000 (OR, 1.7; 95% CI, 1.3-2.1); children younger than 18 years living in the home (OR, 2.0; 95% CI, 1.5-2.6); and ending a relationship within the past year (OR, 7.0; 95% CI, 5.5-8.9). Conclusion.-If the prevalence of abuse in community hospitals throughout the United States is similar to the range of prevalence estimates found in this study, then heightened awareness of intimate partner abuse is warranted for patients presenting to the ED.

“Between me and the computer”: Increased detection of intimate partner violence using a computer questionnaire

“…None have had a positive long-term effect on rates of IPV screening by staff. 10,[38][39][40] We found that allowing patients to self-disclose risks on a computer resulted in a substantially higher rate of IPV detection compared with the rate in a group that received usual care, but it did not guarantee charting and follow-up by the treating physician. Computerassisted disclosure of IPV risk resulted in physician (21) 35 (15) Men (n=78) 45 (18) 37 (16) Women (n=170) 41 (21) 33 (14) 5 33 (13) Partner with depression 6 18 (7) High-risk sexual behavior 7 60 (24) History of sexual abuse or assault 8 39 ( 11 (14) 15 (9) Are you worried that you might physically hurt someone 7 (9) 9 (5) close to you?…”

“…The percentage of missing charts did not vary by whether the patient had received com- estimates, 37 as well with previous studies of IPV screening. 7,8,38 ED screening programs that educate staff about the importance of IPV achieve a similarly high initial rate of detection, but detection decreases dramatically over time. Several researchers have explored staff barriers to screening for IPV and used a variety of staff-centered educational modalities and system modifications to support the process.…”

Caracterização dos casos de violência doméstica contra a mulher atendidos em dois hospitais públicos do Rio de Janeiro

“…Cardoso (1996), com base no relatório do America's Watch -Projeto dos Direitos Humanos das Mulheres -, de 1992, que aborda a violência contra a mulher no Brasil, observa que mais de 40% das agressões contra mulher registradas envolvem golpes, bofetadas, amarração, pancadas, queimadura dos seios e da genitália e estrangulamento. Tais dados, que apontam a gravidade das lesões, indicam uma possível explicação para o fato de mulheres vitimadas que não recebem o apoio de ações preventivas demandarem mais atendimentos de emergência, hospitalização e atendimentos ambulatoriais do que as mulheres que não são vítimas de violência (Dearwater et al, 1998).…”

“…Se, por um lado, é claro que o atendimento emergencial deve prestar um atendimento clínico e cirúrgico de qualidade, por outro, não pode se restringir ao socorro médico. É preciso discutir o potencial papel de desencadeador de atenção e acompanhamento que o setor de emergência pode representar (Dearwater, 1998). Editorial do American Journal of Public Health discute o problema, deixando claro que as limitações são as mesmas, ou seja, até mesmo em países de economia desenvolvida (mesmo nos Estados Unidos), os casos atendidos nem sempre são registrados e não há um acompanhamento posterior.…”

Health Care Utilization and Unhealthy Behaviors Among Victims of Sexual Assault in Connecticut: Results from a Population-Based Sample

“…11 More recent studies described a mixed picture of increased utilization of emergency and urgent care resources and decreased utilization of primary care or routine health services. 8 Furthermore, most studies on the associations between health care utilization and sexual assault use convenience samples derived from emergency rooms, 12,13 HMO populations 3 or clinics and community-based health centers. [14][15][16][17][18] Since sexual assault victims infrequently access health services, population-based studies are needed to examine this phenomenon in more detail.…”