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Intimate Partner Violence Among Women Presenting to a University Emergency DepartmentIntimate Partner Violence Among Women Presenting to a University Emergency Department  [cached]
Wenker, Kerilee,Gorchynski, Julie
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2004,
Abstract: Objective: To establish point and one-year prevalence data regarding partner violence (PV) for women presenting to a university teaching hospital, University of California, Irvine Medical Center (UCIMC), one of 15 emergency departments in Orange County, and to determine differences in partner violence rates when comparing descriptive variables such as race, income and education. Methods: An anonymous, written survey was administered to a convenience sample of 370 women presenting to University of California Irvine Emergency Department over a 12 month period. Results: Partner violence has a point prevalence of 6.7% and a one-year prevalence of 37.0%. Women who have experienced previous abuse are more likely to present with complaints related to PV acutely. Lower income levels correlate with a higher incidence of physical, emotional, and sexual abuse. We found no correlation between race and likelihood of PV. Conclusion: PV in Orange County, California occurs quite frequently. The oneyear prevalence compares to that of the entire state of California, but is at the higher limit when other areas are compared. Detection rates among EPs should be improved, and services to women who have suffered PV will need to be enhanced within Orange County.
Prevalence of intimate partner violence in patients presenting with traumatic injuries to a Guyanese emergency department
Kendra P Parekh, Stephan Russ, David A Amsalem, Navindranauth Rambaran, Shannon Langston, Seth W Wright
International Journal of Emergency Medicine , 2012, DOI: 10.1186/1865-1380-5-23
Abstract: Retrospective descriptive analysis of a prospectively collected ED quality assurance database. Patients 18?years or older who presented with a traumatic injury and answered the question “Was the injury inflicted by a domestic partner?” were included in the analysis.Overall, 38 of 475 (8%) patients admitted to having injuries inflicted by a domestic partner. Thirty- one (81.6%) patients disclosing IPV were female and 7 (18.4%) were male. The self- reported prevalence of IPV in females presenting with traumatic injuries was 16% compared to 2% for males (RR 6.4; 95% CI 2.9-14.3). IPV was the cause of 31 of the 67 (46.3%) women presenting with assaults.IPV is thought to be a serious problem in Guyana, and this study confirms a high prevalence (16%) of IPV in women presenting with traumatic injuries to the Georgetown Public Hospital Corporation ED. This is likely a significant underestimate of the true prevalence.
Intimate partner violence screening in the emergency department  [cached]
Daugherty J,Houry D
Journal of Postgraduate Medicine , 2008,
Abstract: Background and Aims: Every year between 1.5 and 4 million women are abused by a partner in the United States and many abused women turn to the Emergency Department (ED) as their first source of care. Even though the vast majority of patients would feel comfortable disclosing intimate partner violence (IPV) to their physician, identification and referral is inconsistent . Aims: The aim of this paper was to discuss prevalence statistics of IPV, current screening recommendations and practices in ED settings, and future directions to improve the screening and identifying of victims of IPV that present to the ED. Material and Methods: The authors conducted a Medline search for articles discussing IPV screening in the ED. Results: Intimate partner violence results in approximately 1,300 deaths and 2,000,000 injuries annually among women and up to a third of ED patients have a history of IPV. Despite patients′ reported willingness to disclose this information, identification of IPV by healthcare practitioners remains very low, with some estimates ranging between 4-10%. Conclusions: If we do not identify victims of IPV in the ED, this may result in continuation of the abuse, routine returns to the ED for treatment of injuries, and possibly even death.
Rural-Urban Disparities in Emergency Department Intimate Partner Violence Resources  [cached]
Choo, Esther K,Newgard, Craig D,Lowe, Robert A,Hall, Michael K
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2011,
Abstract: Objective: Little is known about availability of resources for managing intimate partner violence (IPV) at rural hospitals. We assessed differences in availability of resources for IPV screening and management between rural and urban emergency departments (EDs) in Oregon. Methods: We conducted a standardized telephone interview of Oregon ED directors and nurse managers on six IPV-related resources: official screening policies, standardized screening tools, public displays regarding IPV, on-site advocacy, intervention checklists and regular clinician education. We used chi-square analysis to test differences in reported resource availability between urban and rural EDs. Results: Of 57 Oregon EDs, 55 (96%) completed the survey. A smaller proportion of rural EDs, compared to urban EDs, reported official screening policies (74% vs. 100%, p=0.01), standardized screening instruments (21% vs. 55%, p=0.01), clinician education (38% vs. 70%, p=0.02) or on-site violence advocacy (44% vs. 95%, p<0.001). Twenty-seven percent of rural EDs had none or one of the studied resources, 50% had two or three, and 24% had four or more (vs. 0%, 35%, and 65% in urban EDs, p=0.003). Small, remote rural hospitals had fewer resources than larger, less remote rural hospitals or urban hospitals. Conclusion: Rural EDs have fewer resources for addressing IPV. Further work is needed to identify specific barriers to obtaining resources for IPV management that can be used in all hospital settings. [West J Emerg Med. 2011;12(2):178-183.]
The training needs of Turkish emergency department personnel regarding intimate partner violence
H Asli Aksan, Feride Aksu
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-350
Abstract: A cross-sectional study was conducted in a large university hospital via questionnaire. The study population consisted of all the nurses and physicians who worked in the ED during a two month period (n = 215). The questionnaire response rate was 80.5% (41 nurses and 132 physicians). The main domains of the questionnaire were knowledge regarding the definition of IPV, clinical findings in victims of IPV, legal aspects of IPV, attitudes towards IPV, knowledge about the characteristics of IPV victims and abusers, and professional and personal experiences and training with respect to IPV.One-half of the study group were females, 76.3% were physicians, and 89.8% had no training on IPV. The majority of the nurses (89.5%) and physicians (71.1%) declared that they were aware of the clinical appearance of IPV. The mean of the knowledge scores on clinical knowledge were 8.84 ± 1.73 (range, 0–10) for acute conditions, and 4.51 ± 3.32 for chronic conditions. The mean of the knowledge score on legal procedures and the legal rights of the victims was 4.33 ± 1.66 (range, 0–7). At least one reason to justify physical violence was accepted by 69.0% of females and 84.7% of males, but more males than females tended to justify violence (chi square = 5.96; p = 0.015). However, both genders accepted that females who experienced physical violence should seek professional medical help.The study participants' knowledge about IPV was rather low and a training program is thus necessary on this issue. Attention must be given to the legal aspects and clinical manifestations of IPV. The training program should also include a module on gender roles in order to improve the attitudes towards IPV.Intimate partner violence (IPV) has a deteriorating influence on society by affecting victims, their children, families, and friends, as well as social and financial relationships. Abused females who have poor physical and mental health suffer more injuries and use more medical resources than non-abused fem
Identifying the Turning Point: Using the Transtheoretical Model of Change to Map Intimate Partner Violence Disclosure in Emergency Department Settings  [PDF]
Cristina Catallo,Susan M. Jack,Donna Ciliska,Harriet L. MacMillan
ISRN Nursing , 2012, DOI: 10.5402/2012/239468
Abstract: Background. The transtheoretical model of change (TTM) was used as a framework to examine the steps that women took to disclose intimate partner violence (IPV) in urban emergency departments. Methods. Mapping methods portrayed the evolving nature of decisions that facilitated or inhibited disclosure. This paper is a secondary analysis of qualitative data from a mixed methods study that explored abused women’s decision making process about IPV disclosure. Findings. Change maps were created for 19 participants with movement from the precontemplation to the maintenance stages of the model. Disclosure often occurred after a significant “turning point event” combined with a series of smaller events over a period of time. The significant life event often involved a weighing of options where participants considered the perceived risks against the potential benefits of disclosure. Conclusions. Abused women experienced intrusion from the chaotic nature of the emergency department. IPV disclosure was perceived as a positive experience when participants trusted the health care provider and felt control over their decisions to disclose IPV. Practice Implications. Nurses can use these findings to gauge the readiness of women to disclose IPV in the emergency department setting. 1. Introduction The emergency department may offer a “window of opportunity” for women to discuss their experiences of intimate partner violence (IPV) with nurses and other health care providers. Exposure to IPV impacts women’s health leading to acute and long-term physical and mental impairment [1–4]. Lifetime prevalence of IPV reported in the emergency department ranged from 37% [5] to as high as 50% [6]. The emergency department is a health care setting where abused women often seek treatment and may disclose at higher rates than other health care settings [7–9]. Due to the frequency with which abused women seek health care, many health care settings continue to adopt IPV-screening initiatives, and health care providers are encouraged to ask about violence as part of their routine care of women [4, 10, 11]. While abused women may seek care in the emergency department, many travel through the system without being recognized as exposed to violence [12]. This is problematic in that nurses, who may be the first point of contact for abused women, may miss an important opportunity for assessment. This is compounded by the fact that emergency department nurses, like other health care providers, continue to face challenges in the detection and documentation of IPV [13–15]. Common barriers to
Association between Intimate Partner Violence and Health Behaviors of Female Emergency Department Patients  [cached]
Anitha Elizabeth Mathew,Brittany Marsh,L. Shakiyla Smith,Debra Houry
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2012,
Abstract: Introduction: We assessed the correlation between intimate partner violence (IPV) and health behaviors, including seat belt use, smoke alarm in home, handgun access, body mass index, diet, and exercise. We hypothesized that IPV victims would be less likely to have healthy behaviors as compared to women with similar demographics.Methods: All adult female patients who presented to 3 Atlanta-area emergency department waiting rooms on weekdays from 11AM to 7PM were asked to participate in a computer-based survey by trained research assistants. The Universal Violence Prevention Screen was used for IPV identification. The survey also assessed seatbelt use, smoke alarm presence, handgun access, height, weight, exercise, and diet. We used chi-square tests of association, odds ratios, and independent t-tests tomeasure associations between variables.Results: Participants ranged from 18 to 68 years, with a mean of 38 years. Out of 1,452 respondents, 155 patients self-identified as white (10.7%), and 1,218 as black (83.9%); 153 out of 832 women who were in a relationship in the prior year (18.4%) screened positive for IPV. We found significant relationships between IPV and not wearing a seatbelt (p,0.01), handgun access (p,0.01), and eating unhealthy foods (p,0.01).Conclusion: Women experiencing IPV are more likely to exhibit risky health behaviors than women who are not IPV victims. [West J Emerg Med. 2012;13(3):278–282.]
A study of intimate partner violence among females attending a Teaching Hospital out-patient department
KALA Kuruppuarachchi,LT Wijeratne,GDSSK Weerasinghe,MUPK Peris
Sri Lanka Journal of Psychiatry , 2010,
Abstract: Background: Intimate partner violence (IPV) is considered a public health problem with physical and psychological consequences. Aims: To describe the prevalence of IPV among married females attending the out-patient department of North Colombo Teaching Hospital and their attitude towards abuse. Methods: A pre-tested self-administered questionnaire on physical, verbal, sexual and emotional abuse was given to the first 50 consenting married females attending the out-patient department on each day for five consecutive days. Confidentiality of responses was assured and adequate privacy was provided for the questionnaires to be completed. Results: Of the 242 participants 98(40.5%) reported some form of abuse by their male partner. Prevalence of abuse reported was physical abuse 19%, verbal abuse 23%, emotional abuse 23% and sexual abuse 7%. A quarter (26.9%) of those inflicted physical violence sought medical treatment for the injuries but only two of them divulged the reason for the injury to medical staff. More than three quarters (79%) of those abused were in the relationship for more than ten years. The majority of the females surveyed believed that violence by the male partner should be tolerated. Conclusions: IPV is a common problem that is poorly divulged to medical personnel. Attitudes regarding IPV have to be changed in order to reduce abuse significantly.
Screening of women for intimate partner violence: a pilot intervention at an outpatient department in Tanzania
Rose M. Laisser,Lennarth Nystr?m,Gunilla Lindmark,Helen I. Lugina
Global Health Action , 2011, DOI: 10.3402/gha.v4i0.7288
Abstract: Intimate partner violence (IPV) is a public health problem in Tanzania with limited health care interventions.To study the feasibility of using an abuse screening tool for women attending an outpatient department, and describe how health care workers perceived its benefits and challenges.Prior to screening, 39 health care workers attended training on gender-based violence and the suggested screening procedures. Seven health care workers were arranged to implement screening in 3 weeks, during March–April 2010. For screening evaluation, health care workers were observed for their interaction with clients. Thereafter, focus group discussions (FGDs) were conducted with 21 health care workers among those who had participated in the training and screening. Five health care workers wrote narratives. Women's responses to screening questions were analyzed with descriptive statistics, whereas qualitative content analysis guided analysis of qualitative data.Of the 102 women screened, 78% had experienced emotional, physical, or sexual violence. Among them, 62% had experienced IPV, while 22% were subjected to violence by a relative, and 9.2% by a work mate. Two-thirds (64%) had been abused more than once; 14% several times. Almost one-quarter (23%) had experienced sexual violence. Six of the health care workers interacted well with clients but three had difficulties to follow counseling guidelines. FGDs and narratives generated three categories Just asking feels good implied a blessing of the tool; what next? indicated ethical dilemmas; and fear of becoming a 'women hospital’ only indicated a concern that abused men would be neglected.Screening for IPV is feasible. Overall, the health care workers perceived the tool to be advantageous. Training on gender-based violence and adjustment of the tool to suit local structures are important. Further studies are needed to explore the implications of including abuse against men and children in future screening.
Correlation Between Intimate Partner Violence Victimization and Risk of Substance Abuse and Depression among African-American Women Seen in an Urban Emergency Department  [cached]
Hankin, Abigail,Smith, L. Shakiyla,Daugherty, Jill,Houry, Debra
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2010,
Abstract: Objective: To assess rates of substance abuse (including tobacco, alcohol, and drug abuse) as well as rates of intimate partner violence (IPV) among African-American women seen in an urban Emergency Department (ED). Methods: Eligible participants included all African-American women between the ages of 21-55 years old who were seen in an urban ED for any complaint, and who were triaged to the waiting room. Eligible women who consented to participate were taken to complete a computer-based survey that focused on demographic information and general health questions as well as standardized instruments including the Index of Spouse Abuse (ISA), the Tolerance, Worried, Eye openers, Amnesia, K(C)ut down (TWEAK) screen for alcohol abuse, Drug Abuse Screening Test (DAST20), and Hooked on Nicotine Checklist (HONC). This analysis uses results from a larger study evaluating the effects of providing patients with targeted educational literature based on the results of their screening. Results: 610 women were surveyed. Among these, 85 women (13.9%) screened positive for IPV. Women who screened positive for IPV were significantly more likely to also screen positive for tobacco abuse (56% vs. 37.5%, p< 0.001), alcohol abuse (47.1% vs. 23.2%, p < 0.001), and drug abuse (44.7% vs. 9.5%, p<0.001). Women who screened positive for IPV were also more likely to screen positive for depression and to report social isolation. Conclusion: African-American women seen in the ED, who screen positive for IPV, are at significantly higher risk of drug, alcohol, tobacco abuse, depression and social isolation than women who do not screen positive for IPV. These findings have important implications for ED-based and community-based social services for women who are victims of intimate partner violence. [West J Emerg Med. 2010; 11(3): 253-257.]
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