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You're not a victim of domestic violence, are you?
This is the title of an article in the Annals of Internal Medicine about screening for domestic violence in emergency rooms. Unfortunately the title tells much of the story. Since October is domestic violence awareness month I thought it would be good to visit this problem that plagues all of our communities. Many victims visit emergency rooms as a result of domestic violence injuries. This study that took place in emergency rooms in two large hospitals, one urban and one suburban, demonstrated that the question that a health care professional asks makes a big difference. The researchers audio taped emergency room interviews of women who were not medically emergencies and consented to the audio taping. Missed opportunities: This research found that screening for domestic violence only occurred for 34% of women who could be interviewed. Domestic violence is a problem: When there was a domestic violence inquiry 26% (n=77) of women disclosed either a current or past problem. It is possible that 150 additional cases of domestic violence would have been revealed if the other 66% of the women would have been screened.More missed opportunities: The study found that medical staff inquires were "often perfunctory," did not usually include follow-up questions or opportunities to talk. Only 31% were documented in the medical record and only 25% were referred for counseling.So what about Lawrence? The emergency room at Lawrence Memorial Hospital does better. According to Belinda Rehmer who is the LMH communications coordinator personnel use a computer generated list of questions when someone is comes to the emergency room. The domestic violence question is: Do you feel safe at home? If the answer is no an automatic referral is made to a hospital social worker. The study was conducted only with women. Women are victims of abuse much more than men. But some men are victims. I was once in a hospital recovery room (in another community) after an outpatient procedure and a nurse asked me a question about domestic violence. After I recovered from my surprise I was pleased that my hospital cared enough to ask.If you use a different hospital other than Lawrence Memorial and share my concern for domestic violence, ask them how their emergency room staff asks patients about the problem. Rhodes, K.V., Frankel, R.M., Levinthal, N., Prenoveau, E., Baily, J., & Levinson, W. (2007). "You're not a victim of domestic violence, are you? Provider communication about domestic violence."Annals of Internal Medicine, (147), pp. 620-627.