The Factors Associated with Disclosure of Intimate Partner Abuse to Clinicians

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Original Research

The Factors Associated with Disclosure of Intimate Partner Abuse to Clinicians

J Fam Pract. 2001 April;50(4):338-344

References

1. Straus M, Gelles R. Societal change and change in family violence from 1975 to 1985 as revealed by two national surveys. J Marriage Fam 1986;48:465-79.

2. Plichta SB, Duncan MM, Plichta L. Spouse abuse, patient-physician communication, and patient satisfaction. Am J Prev Med 1996;12:297-303.

3. McCauley J, Kern DE, Kolodner K, et al. The ‘battering syndrome’: prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. Ann Intern Med 1995;123:737-46.

4. Hamberger LK, Saunders DG, Hovey M. Prevalence of domestic violence in community practice and rate of physician inquiry. Fam Med 1992;24:283-87.

5. Council on Scientific Affairs. American Medical Association. Violence against women: relevance for medical practitioners. JAMA 1992;267:3184-89.

6. Friedman LS, Sarnet JH, Roberts MS, et al. Inquiry about victimization experiences: a survey of patient p and physician practices. Arch Intern Med 1992;152:1186-90.

7. Caralis PV, Musialowski R. Women’s experiences with domestic violence and their attitudes and expectations regarding medical care of abuse victims. South Med J 1997;90:1075-80.

8. Gin NE, Rucker L, Frayne S, et al. Prevalence of domestic violence among patients in three ambulatory care internal medicine clinics. J Gen Intern Med 1991;6:317-22.

9. Straus MA, Smith C. Family patterns and primary prevention of family violence. Trends in health care, law & ethics 1993;8:17-26.

10. Rodríguez MA, Bauer HM, McLoughlin E, Grumbach K. Screening and intervention for intimate partner abuse: practices and attitudes of primary care physicians. JAMA 1999;282:468-74.

11. Bauer HM, Rodríguez MA, Pérez-Stable EJ. Prevalence and determinants of intimate partner abuse among public hospital primary care patients JGIM In press.

12. Brislin RW. Back-translation for cross-cultural research. J Cross-Cultural Psych 1970;1:185-216.

13. Soeken K, Parker B, McFarlane J, et al. The abuse assessment screen: a clinical instrument to measure frequency, severity, and perpetrator of abuse against women. In: Campbell JC, ed. Empowering survivors of abuse: health care for battered women and their children. Thousand Oaks, Calif: Sage Publications; 1998.

14. SPSS. Version 8.0 for Windows. Chicago, Ill: SPSS, Inc; 1998.

15. West CM, Kantor GK, Jasinski JL. Sociodemographic predictors and cultural barriers to help-seeking behavior by Latina and Anglo American battered women. Violence Victims 1998;13:361-75.

16. Bauer HM, Rodríguez MA, Quiroga SS, Flores-Ortiz YG. Barriers to health care for abused Latina and Asian immigrant women. J Health Care Poor Underserved 1999;11:33-44.

17. Morales LS, Cunningham WE, Brown JA, et al. Are Latinos less satisfied with communication by health care providers? J Gen Intern Med 1999;14:409-17.

18. Baker DW, Parker RM, Williams MV, et al. Use and effectiveness of interpreters in an emergency department. JAMA 1996;275:783-88.

19. Rodríguez MA, Quiroga SS, Bauer HM. Breaking the silence: battered women’s perspectives on medical care. Arch Fam Med 1996;5:153-58.

20. Sugg NK, Inui T. Primary care physicians’ response to domestic violence: opening Pandora’s box. JAMA 1992;267:3157-60.

21. Rodríguez MA, McLoughlin E, Bauer HM, et al. Mandatory reporting of intimate partner violence to police: views of physicians in California. Am J Public Health 1999;89:575-78.

22. Gerbert B, Caspers N, Bronstone A, et al. A qualitative analysis of how physicians with expertise in domestic violence approach the identification of victims. Ann Intern Med 1999;131:578-84.

23. Parsons LH, Zaccaro D, Wells B, Stovall TG. Methods of and attitudes toward screening obstetrics and gynecology patients for domestic violence. Am J Obstet Gynecol 1995;173:381-87.

24. Tilden VP, Schmidt TA, Limandri BJ, et al. Factors that influence clinicians’ assessment and management of family violence. Am J Public Health 1994;84:628-33.

25. Harwell TS, Casten RJ, Armstrong KA, et al. Results of a domestic violence training program offered to the staff of urban community health centers. Am J Prev Med 1998;15:235-41.

Suggestions for future research

Although our findings support the need for direct clinician inquiry about IPA among all women patients in the medical setting, there is a need for more information about how to most effectively screen patients, particularly among demographically diverse populations. There is also a need for clarification around the meaning of “routine screening” and for information about the extent to which differences in screening practices might affect communication outcomes. These differences include factors such as the type of clinician doing the screening and the frequency of screenings (ie, screenings at every visit vs annually vs only if the patient is in a new relationship).

Relatively little is known about clinician-patient communication patterns among different immigrant groups in the United States. Although our study examined the general influence of birthplace on communication outcomes, most of the immigrant women in our study were from Spanish-speaking countries, and immigration was not a focus of our study. Future research might look specifically at determinants of communication among various immigrant groups in the United States, in particular, Asian women, about whom relatively little is known regarding abuse-related communication.

Finally, we were unable to specifically examine the determinants of decreased IPA communication among immigrant women. It is possible that decreased communication within this population may have resulted from less contact with the medical system or from differential treatment by medical clinicians. Future research might look more closely at this issue.

Acknowledgements

Our research was supported by the Commonwealth Foundation and by a grant under the Resource Centers for Minority Aging Research Program by the National Institute on Aging, the National Institute of Nursing, and the Office of Research on Minority Health, National Institute of Health, grant # 1 P30 AG15272. Dr Rodriguez was a Picker/Commonwealth Scholar when this work was completed. We wish to thank Drs Kevin Grumbach and Elizabeth McLoughlin for assistance with study design, Dr Liza Pressor for data collection, and Gregory Nah for data management. In addition, we thank the many San Francisco advocates against domestic violence for their input into the survey content and design, and we thank the women who participated in our study.

Related resources

National Domestic Violence Hotline http://www.ndvh.org, 1-800-799-SAFE (7233), 1-800-787-3224 (TDD)
The Family Violence Prevention Fund http://www.fvpf.org/
Intimate Partner Violence and Sexual Assault: A Guide to Training Materials and Programs for Healthcare Providers http://www.cdc.gov/ncipc/pub-res/pdf/newguide.pdf
American Medical Association Violence Prevention Website http://www.ama-assn.org/ama/pub/category/3242.html