Intimate
partner violence is characterized by behavioral patterns that include physical
abuse, emotional/psychological abuse, sexual abuse, threats, intimidation,
stalking and deprivation5. These behaviors are normally
perpetuated by one’s former or current intimate partner. According to the
national coalition against domestic violence, an average of 20 people are
physically abused by their intimate partners every minute. This means that approximately
10 million people in the US experience some form of intimate partner abuse
annually3. Statistics shows that 25% of women
and 7.6% of men will be victims of domestic violence in their lifetime4.
IPV can happen to people of all ages, educational and cultural backgrounds.
The consequences and prevalence of intimate
partner violence nationally makes it a health crisis that needs to be addressed
and prevented. Unfortunately, most victims of intimate partner violence do not
report the case to the appropriate authorities but often find excuses to
justify the actions of the abusers. Research shows that health care professionals,
especially Physicians can play an important role in detection, intervention and
prevention of IPV due to the unique relationship they have with patients4.This
is why it is important that physicians screen their patients for domestic
abuse. Screening creates an opportunity for healthcare workers to educate their
patients on the dangers and consequences of domestic abuse on their health.
Due to the sensitivity of domestic abuse,
it is essential for physicians to be very discreet in their assessment when
screening for it. Studies have shown that patients are more likely to open up
about their feelings if asked in confidence away from family and in a nonjudgmental,
respectful manner. There are two different ways of screening- written survey
and oral screening using either direct or indirect questions. Since some people
may be offended when isolated to be screened privately for domestic violence,
it is recommended that physicians introduce the conversation with statements
such as “Because violence is very common, I ask all my patients about their
experience with violence”. Direct questions are preferred mostly in a situation
when domestic violence is already suspected based on the observations made by
the physician.
The response from the physician after a
patient opens up about domestic abuse, is also very important. A nonjudgmental
and supportive statement is essential to create a congenial atmosphere for the
patients to explore solutions. The immediate concern for a physician should be the
safety of the patient. Victims of domestic violence are at higher risk of death
when they leave their partners, so it is important that they determine the best
time to leave the relationship in order to ensure their safety. In states that physicians are not mandated to report intimate partner violence, the best way
to help patients is to offer them resources that can help them plan for ways to
ensure their safety, educate them on the physical and psychological effects of IPV
and refer them to access services that are available to them.
Akua Boadu (MS4)
Drexel University College of Medicine
Resources
- Lizdas C Kristen, Durborow Nancy,
O’flaherty Abigail, Marjavi Anna; Compendium of State Statutes and
Policies on Domestic Violence and Health Care, 2010, https://www.acf.hhs.gov/sites/default/files/fysb/state_compendium.pdf
- Pennsylvania Coalition Against
Domestic violence, 2018, http://www.pcadv.org/Learn- More/
- National Coalition Against
Domestic Violence, 2018, https://ncadv.org/statistics?gclid=Cj0KCQjw1q3VBRCFARIsAPHJXrFq0k5XaHQoXI
W0zdld_NG1rMC02xsc1JPcPViYv65UafLDOe8NXwcaAtgBEALw_wcB
- Cronholm Peter, Fogarty Colleen,
Ambuel Bruce, Harrison Leonard Suzanne; Intimate Partner Violence, 2011,
https://www.aafp.org/afp/2011/0515/p1165.html
- Guidelines for the Health Care of
Intimate Partner Violence, 2004,
http://domesticabuse.stanford.edu/screening/law.html
- https://www.cdc.gov/violenceprevention/intimatepartnerviolence/index.html
