Beyond assessment: Examining providers’ responses to disclosures of violence

Abstract

Purpose Intimate partner violence (IPV) and sexual assault (SA) are significant public health issues. In spite of gains made in research and support for screening, little is known about how healthcare providers respond to disclosures of violence. The purpose of this analysis was to examine providers’ documented responses to women's disclosure of IPV or SA. Data sources This qualitative analysis of healthcare providers’ responses to the disclosure of violence was part of a larger retrospective review of 2000 medical records from four family planning clinics in the northeastern United States. Conclusions Findings from this analysis reveal that although screening for IPV and past experiences of violence is consistent, providers’ responses to disclosures of violence are often inconsistent. The majority of documented responses to the disclosure of violence (81.5%) were only descriptive in nature and 13% of the medical records contained no documentation of the violence. Implications for practice As universal violence assessment has increased, providers need to be aware of not only how to screen for violence, but how to respond in a way that is helpful, sincere, nonjudgmental, and legally adequate. This will require providers to move beyond a description of violence toward a response that is action‐oriented and includes safety planning and referrals.

Health consequences of adverse childhood experiences: A systematic review

“…It is essential that NPs become knowledgeable about appropriate counseling services in their area and offer to refer patients (Read et al., ; Sutherland, Fontenot, & Fantasia, ). Currently there are no guidelines for addressing ACE in primary care; however, such a guideline may be useful to NPs as they begin asking about ACE.…”

Intimate partner violence management and referral practices of primary care workers in a selected population in Turkey

“…In this study, we found that FPs recorded a 'code of violence' in only 64% of the IPV cases they encountered, while M/ Ns informed the physician in only 41% of the IPV cases they acknowledged. A study from the United States in 2014 reported that, of physicians who screened patients for IPV, the vast majority (81.5%) did not act appropriately, such as offering a follow-up appointment or making a referral to IPV facilities (Sutherland et al, 2014). In a study reviewing affirmed IPV cases, researchers found that IPV was reported by health institutes in only 31 (9.1%) cases of the 337 records reviewed (Magnussen et al, 2004).…”

Screening for Intimate Partner Violence

“…Following a positive screen, the clinician has the responsibility to take the following additional actions: 1) complete additional assessments, 2) offer safety planning, and 3) offer referrals . Gathering detailed information through additional assessment to clarify the woman's experience and situation is necessary.…”

“…Determining timing of the last abusive event and whether sexual violence was involved will direct provision of referrals to sexual assault/forensic nursing services, as the jurisdiction where the assault occurred will have evidence collection time limits, which are usually 72 to 120 hours. There is a strong correlation between IPV and depression, posttraumatic stress, substance use, traumatic brain injury, and reproductive coercion . Thus, screening for depression and substance abuse are also recommended.…”

“…Strategies may include keeping copies of vital records (eg, birth certificates, Social Security cards, passports) and money hidden or at a trusted friend's house for a quick escape, discussing ways to protect young children, and knowing/taking steps for obtaining a restraining order. This may seem an overwhelming amount of content to review for busy clinicians; if time is constrained, the clinician can refer the woman to someone who provides safety planning, such as a community‐based IPV advocate group or crisis hotline.…”