How far does screening women for domestic (partner) - NIHR Health ...

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Review Question III
McDonnell and colleagues 112 recruited 481 patients
attending their first antenatal appointment at
an Irish hospital. Of the women who answered
the questions regarding acceptability of partner
violence screening, 468 (99%) found the questions
acceptable and considered that all women should
be asked these questions. There were no differences
in acceptability by abuse status or by age.
A study by McNutt and colleagues 113 recruited
women from a health maintenance organisation
(HMO), partner violence programmes and refuges.
The survey incorporated questions on what women
want nurses and physicians to ask, and what they
want them to do and not do in order to help
abused women. Forty percent of women in the
HMO and community-based programmes and 64%
in refuges agreed with screening.
Newman and colleagues 114 conducted a survey of
451 women who were unaccompanied by a male
partner in a paediatric emergency department in
a US hospital. When asked if it was appropriate to
screen them for partner violence when they sought
care for their children, 75% of women stated it
was. Forty-four percent preferred direct verbal
questioning, 36% a written questionnaire, and 20%
suggested other methods of screening.
Renker and Tonkin 102 used anonymous computer
interviews in two maternity units in the USA.
Topics covered in the interview included screening
and interventions, past disclosure to health-care
providers, preferences or attitudes towards violence
screening, pregnancy violence and violence severity
screening. Feelings of anger, embarrassment
or being offended were not experienced by
the majority (97%) of women screened by their
prenatal care providers for partner abuse.
Richardson and colleagues 41 surveyed 1207 women
in 13 randomly selected general practices in
London. Eighty percent of women reported that
they would not mind being asked by their general
practitioner about abuse or violence in their
relationship if they had come about something else.
Romito and colleagues 107 conducted a survey
in six family practice sites in Italy. Women were
approached and asked if they would like to
participate in a study to improve how health
services respond to women’s health problems.
Eighty-five percent of respondents believed the
family doctor should ask all women about violence,
7% thought doctors should not ask, and 8%
were uncertain. A higher percentage of women
experiencing current abuse agreed that doctors
should ask about abuse compared with women
not currently experiencing abuse, although this
association was not significant. Younger women
were significantly less likely to agree that all doctors
should ask about abuse.
Sethi and colleagues 48 administered a modified
World Health Organization (WHO) Multi-country
Domestic Violence Study questionnaire in an
inner-city accident and emergency department
in a British hospital. The questions asked about
the nature of violence and abuse experienced
and women’s views on being asked about abuse in
an accident and emergency department setting.
Overall, 76% felt comfortable when asked about
partner violence. Eighteen percent felt slightly
uncomfortable, 5% felt uncomfortable and
1% felt very uncomfortable. Feelings of being
uncomfortable were higher in those who had
experienced abuse compared with those who had
not (10% versus 3%, p = 0.02). In response to a
question about the desirable frequency of being
asked about partner violence, 35% felt it should be
on all occasions, 26% felt they should usually be
asked, 38% said seldom and 2% felt never. Many
women commented on the need for privacy and
safety and expressed concern about direct questions
being asked of women presenting with injuries.
Zeitler and colleagues 115 recruited women aged
between 15 and 24 years who presented for family
planning services to a US clinic. Almost 90% of
those surveyed felt that universal screening by
health-care providers is a ‘very good’ or ‘somewhat
good’ idea. When respondents were categorised
according to how much they minded being asked
about violence, there were no differences according
to ethnicity, school enrolment, parity, family
violence or lifetime dating violence experience.
However, compared with women aged 19–21 years,
women aged 15–18 years were 2.9 times more likely
to voice some concern regarding violence screening
by a provider (36%, p < 0.01).
Webster and colleagues 116 administered a selfreport
questionnaire to 1313 women from five
Australian hospitals during the visit following
the consultation at which they had been screened
for partner violence. Ninety-eight percent of
respondents believed it was a good idea to ask
women about partner violence when visiting a
hospital. There was no difference in the responses
of women from rural, remote or inner city sites,
nor were there differences between sites in terms
of how women felt when asked partner violence