Screening for Intimate Partner Violence

Abstract

The barriers that professionals face when screening victims for intimate partner violence (IPV) are well studied. The specific barriers that victims face however when being screened are not. The authors sought to identify characteristics of the screener and screening environment that make a victim feel more or less comfortable when disclosing a history of IPV. One hundred forty self-reported female victims of IPV completed a survey regarding their experiences with screening and degree of comfort with certain traits of the screener and the screening environment. Women demonstrated a preference to be screened by a woman, someone of the same race, a provider aged 30 to 50 years, and without anyone else present. Screeners should be aware of characteristics that impact victim comfort and should provide multiple opportunities for women to disclose IPV in a safe, respectful, and culturally effective environment.

Screening for Intimate Partner Violence against Women in Healthcare Sweden: Prevalence and Determinants

“…Finally, because of its cross-sectional design the study can only confirm associations but cannot draw casual inference. Notwithstanding, these plausible weaknesses many findings are in line with other works suggesting inequalities in screening activity due to demographic, occupational, work-environmental, and structural factors [18–25]. …”

“…Female healthcare professionals were more likely to screen for IPV than male colleagues, corresponding with hypotheses suggesting that women may be more prone to screen for IPV out of sympathy for fellow women. The findings could also be echoing previous work indicating that women patients may be more prone to discuss IPV issues with female professionals [25]. Doctors and nurses appeared better placed than midwives to inquire of IPV exposure.…”

Mental Health, Demographic, and Risk Behavior Profiles of Pregnant Survivors of Childhood and Adult Abuse

“…There are barriers to health care providers screening for childhood maltreatment and adult abuse 16–27 . In addition, women who have had these types of abuse in their lives also experience barriers to disclosure when asked in health care settings 28–34 . Based on epidemiologic survey research, rates of disclosure by clients are far below population estimates of the incidence of abuse 11–12,35,36 .…”

“… Provider characteristics matter, with women preferring to be screened by a woman, of the same race, 30–50 years old, and with nobody else present 28 A sense of trust, support, and nurturing matter 29 Concerns about confidentiality are barriers 29 Some women do not perceive childhood beatings as abuse, but as punishment 76 Some feel it is not relevant to their care 31 Stigma is a barrier, sometimes complicated by fear or perception of discrimination 32,77 Previous negative response from a provider deters future disclosure (e.g., silence, expression of shock with no other reaction, doubt, or expressing the view that the abuse had no relevance to the current medical care) 33,34 African American women exposed to interpersonal violence are significantly more likely to report using prayer as a coping strategy 78 and less likely to seek mental health counseling 78,79 Women experiencing interpersonal violence who have medical insurance coverage are more likely to seek mental health treatment than those without 79 …”

“…Provider characteristics matter, with women preferring to be screened by a woman, of the same race, 30–50 years old, and with nobody else present 28 …”