文章基本信息

标题：Partner Violence Screening in Rural Health Care Clinics
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作者：Ann L. Coker ; Vicki C. Flerx ; Paige H. Smith 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2007
卷号：97
期号：7
页码：1319-1325
DOI：10.2105/AJPH.2005.085357
语种：English
出版社：American Public Health Association
摘要：Objectives. We sought to determine the frequency of intimate partner violence by type in a large, clinic-based, nurse-administered screening and services intervention project. Methods. A brief intimate partner violence screen, which included items to measure sexual and physical assaults and psychological battering (using the Women’s Experience With Battering scale) was administered to consenting women receiving care at 1 of 8 rural clinics in South Carolina. Results. Between April 2002 and August 2005, 4945 eligible women were offered intimate partner violence screening, to which 3664 (74.1%) consented. Prevalence of intimate partner violence in a current (ongoing) relationship was 13.3%, and 939 women (25.6%) had experienced intimate partner violence at some point in the past 5 years. Of those ever experiencing intimate partner violence, the majority (65.6%) experienced both assaults and psychological battering; 10.1% experienced assault only, and 24.3% experienced psychological battering only. Most women (85.5%) currently experiencing both psychological battering and assaults stated that violence was a problem in their current relationship. Conclusions. The intimate partner violence screening technique we used was feasible to implement, acceptable to women seeking health care at the targeted clinics, and indicated a high proportion of women reporting intimate partner violence in the past 5 years, with a majority of those women stating that such violence was a problem in their relationships. These findings demonstrated the viability of the screening technique, which supports the growing importance of implementing intimate partner violence screenings in clinical settings in order to reduce the prevalence of violence in intimate relationships. One in 4 women living in the United States has been physically or sexually assaulted or stalked by an intimate partner during her lifetime. 1 ^, 2 Prevalence estimates for current intimate partner violence (IPV) among women receiving care in primary health care settings range between 7% and 29%. 3 ^– 7 The cost of IPV is conservatively estimated at $5.8 billion per year 8 ; this figure includes $4.1 billion for medical and mental health care, $900 million in lost productivity, and another $900 million in lost earnings from women murdered by their partner. A growing literature has documented the short- and long-term physical and mental health effects of IPV (see Plichta et al. 9 for a recent review). Although IPV is more common than many of the health outcomes for which clinicians routinely screen, few clinicians conduct routine screening for IPV. Yet, validated tools needed for clinical IPV screening exist. 10 ^– 14 Clinicians’ failure to ask about IPV may negatively affect the patient’s trust and confidence in the clinician. 15 Many physician and nursing organizations support IPV screening and consider the identification of violence a professional responsibility. 16 ^– 20 However, the US Preventive Services Task Force recently concluded that there were insufficient data to support IPV screening, stating that additional data are needed to determine whether screening is harmful, whether interventions improve outcomes for women, and whether IPV screening can be adopted in busy clinical settings. 21 We report the results of an ongoing screening and intervention study conducted in health care clinics in rural South Carolina. The population consisted largely of low-income women seeking primary health care at participating clinics. Women aged 18 years and older were eligible for IPV screening, with IPV defined as physical, sexual, or psychological abuse by a current or past partner. Women who tested positive for IPV were offered an intervention at their corresponding clinic and participation in a 2-year cohort study. We present an initial report of baseline IPV screening results. Although screening was offered to all women on an annual basis, we report here the results of the first IPV screening. We aimed to (1) describe our efforts at implementing universal IPV screening, (2) describe the overall frequency of victimization by IPV type and timing (i.e., current or past violence), (3) examine the relationship between past and current violence by IPV type, and (4) examine the extent to which women perceive violence to be a problem in their relationship by IPV type. Details of the intervention are provided elsewhere. 22