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Physicians Less Likely to Screen, But More Likely to Intervene On Domestic Violence
"Only 19
percent of physicians surveyed reported screening new patients for
domestic violence compared with 98 percent for tobacco use, 90 percent
of alcohol abuse, and 47 percent for HIV and sexually transmitted
disease risks," said Barbara Gerbert, Ph.D., of the University of
California, San Francisco. Gerbert was the study’s lead
investigator.
However, once
the problem of domestic violence was identified, the "respondents
reported intervening at comparable or greater frequencies . . .
compared with tobacco, alcohol or HIV/STD risks," Gerbert said.
The
team’s research found that physicians spent longer time periods
counseling identified domestic violence victims than patients
identified as having any of the other three health risks.
Between 1.5
million and 3.9 million women are physically abused each year by their
intimate partners with domestic violence affecting an estimated eight
to 14 percent of primary care patients, according to previous research.
"In addition
to death and immediate trauma, domestic violence results in a number of
chronic health problems," Gerbert explained, and cited depression,
anxiety and substance abuse as some of the most frequently occurring
problems.
Only a small
minority of physicians ask about domestic violence despite these
observations, as well as recommendations for routine screening from
medical organizations and domestic violence experts, and repeated
findings that appropriate screening can be both effective and
beneficial, according to the study.
Gerbert said
survey questionnaires were mailed to a random, national sample of 1,200
physicians specializing in internal medicine or family practice. The
questions on the 32-item survey centered on four health behaviors:
domestic violence, tobacco use, alcohol abuse and HIV/STD risks, she
added.
Low screening
rates for domestic violence were reported by the 610 respondents, the
study determined. At the same time, the physicians reported knowing
"less about how to screen for or intervene with domestic violence than
the other health risks . . . and, compared with alcohol abuse and STDs,
believe they lack appropriate referral resources," said Gerbert.
The responses
also indicate that while 86 percent of physicians believe intervening
with domestic violence is an essential or nearly essential part of
their role, even more (at least 95 percent) feel that way about the
other three problems, according to the findings.
However, the
study revealed that physicians’ self-described interventions to
domestic violence were most intense once identified. Gerbert said that
physicians were far more likely to "provide counseling, arrange for
follow-up visits or calls, and refer patients to additional resources
for domestic violence victims than . . . for patients identified with
the other three health risks."
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