Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000–2015

Abstract

Domestic violence and abuse has been shown to have a direct impact on the health and well-being of survivors who will often access emergency department services with direct injuries and associated medical conditions. This article is relevant to those working in the emergency department in raising awareness in a number of areas of practice for example the prevalence of male intimate partner violence survivors. Furthermore, patients do not always disclose domestic violence and abuse even in cases where there is clear sustained injury thus requiring staff to be vigilant to repeat attendees and patient history. This requires a well-maintained and effective reporting system for instances of suspected and disclosed domestic violence and abuse in order that staff can provide the appropriate care and support. Emergency department staff often deal with complex cases, this includes different aspects of domestic violence and abuse including physical, emotional and psychological abuse. Continual support and guidance, including educational interventions, would assist emergency department clinical staff to manage and discuss instances of domestic violence and abuse in their workplace and their interactions with domestic violence and abuse patients. Whilst training for emergency department staff is welcomed, there also needs to be a greater awareness of the potential complexity of domestic violence and abuse presentations beyond physical injury in order for staff to remain observant throughout consultations. It is also suggested that clear domestic violence and abuse assessment and referral mechanisms should be embedded into clinical practice, including emergency department, as described in the UK National Institute of Clinical Excellence guidelines (2014). Overall improvements in reporting mechanisms in emergency department for the identification, management and support for domestic violence and abuse survivors would add to the collective and growing body of evidence surrounding domestic violence and abuse and their presentations within healthcare settings. Such measures would enable those working in emergency department to support disclosure of domestic violence and abuse more effectively.

Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women

“…Previous research showed that IPV screening was important for women who visit the ER [70]. While there is a debate about universal screening for IPV and universal screening for safety and providing universal information and education on IPV [71,72], it is agreed conducting any form of screening can help women disclose abuse, and help healthcare providers to properly respond to, and treat not only the physical and/or sexual, but also the psychological aspects of IPV [26,73,74]. Among Jewish women, no association was found between IPV screening and receiving information.…”

Sexist Myths Emergency Healthcare Professionals and Factors Associated with the Detection of Intimate Partner Violence in Women

“…Emergency departments treat a large number of women, with it being estimated that between 6% and 54% experience IPV and/or will probably experience it by their current or former partners, especially physical abuse and sexual coercion and particularly if they have little social support [ 15 , 29 , 31 , 52 , 53 ]. It has even been reported that many women who are murdered by their partners/former partners had resorted to emergency services [ 31 ].…”

“…That is why they constitute a privileged attention unit, not only to treat any possible injuries, but also to actually help victims minimise their exposure to abuse, or even to get out of such situation [15,35]. However, the efficacy of emergency services in the detection of IPV cases, particularly during the current health crisis, and of the factors associated with detection by healthcare professionals, including opinions on sexist myths, requires further research [53,54]. Our hypothesis is that professionals showing favourable opinions on certain false beliefs or sexist myths perform a lower detection of IPV cases in emergency services.…”

Contribution of Substance Use in Acute Injuries With Regards to the Intent, Nature and Context of Injury: A CHIRPP Database Study

“…The ED provides a unique opportunity for screening and early intervention for behaviours such as alcohol and substance use [10]. It is often the interface between the traditional health care system and vulnerable populations such as homeless persons [14], domestic violence victims [15] and older adults who are known to be at risk of violence-related events and substance abuse [16]. Various studies support the implementation of substance use screening tools for trauma patients in the ED [1,10] and our results suggest that patients with deliberate physical injuries could potentially deserve greater screening.…”