Abstract

Background

Intimate partner violence (IPV) is a largely undetected occurrence in the United States reported by 36–50% of women in their lifetime and associated with extensive physical and psychological implications. Currently, conflicting recommendations exist regarding screening practices with the United States Preventative Services Task Force (USPSTF) and the World Health Organization (WHO) advocating for and against universal screening, respectively. With research suggesting that women are seldom asked about IPV during clinic visits, further information is needed regarding current screening practices.

Objectives

To identify current IPV screening approaches in the primary care setting and factors that may impact screening completion.

Methods

We retrospectively examined patients presenting for annual examinations at four university-associated primary care clinics in southeast Florida (n = 400). Patient demographics, screener demographics, screening completion, and screening results were collected from the medical record. Results were compared to depression and anxiety screenings due to comparable prevalence and screening recommendations. Pearson chi square and Fisher exact tests were utilized to compare screening rates by demographic characteristics.

Results

IPV screening occurred at a much lower frequency (8.5%) compared to screenings for anxiety (37.3%) and depression (71.3%). Among documented IPV screenings, 64.7% of encounters resulted in patient refusal to be screened. Screening rates were found to be marginally impacted by patient ethnicity (P = 0.052).

Conclusions

Findings of both low screening rates and low screening success raise significant concerns for the shortcomings of advocating for universal IPV screening. Therefore, additional studies are necessary to identify covert barriers to screening completion before universal inquiry is advised.

中文翻译：

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亲密伴侣暴力：对初级保健机构当前筛查实践的分析

摘要

背景

亲密伴侣暴力 (IPV) 是美国 36% 至 50% 的女性在其一生中报告的一种很大程度上未被发现的事件，并且与广泛的身体和心理影响有关。目前，与美国预防服务工作组 (USPSTF) 和世界卫生组织 (WHO) 分别提倡和反对普遍筛查的筛查实践存在相互矛盾的建议。研究表明女性在就诊期间很少被问及 IPV，因此需要有关当前筛查实践的更多信息。

目标

确定初级保健机构中当前的 IPV 筛查方法以及可能影响筛查完成的因素。

方法

我们回顾性地检查了佛罗里达州东南部四家大学相关初级保健诊所（ n = 400）参加年度检查的患者。从病历中收集患者人口统计数据、筛查人口统计数据、筛查完成情况和筛查结果。由于可比较的患病率和筛查建议，将结果与抑郁和焦虑筛查进行了比较。Pearson 卡方检验和 Fisher 精确检验用于比较人口特征的筛查率。

结果

与筛查焦虑（37.3%）和抑郁（71.3%）相比，IPV筛查发生的频率（8.5%）要低得多。在记录的 IPV 筛查中，64.7% 的遭遇导致患者拒绝接受筛查。患者种族对筛查率的影响很小（P = 0.052）。

结论

低筛查率和低筛查成功率的发现引起了人们对提倡普遍 IPV 筛查的缺点的严重关注。因此，在建议进行普遍调查之前，需要进行额外的研究来确定筛查完成的隐蔽障碍。