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Am Fam Physician. 1998;57(10):2528-2529

Women are more likely to experience violence delivered by a current or former partner than by all other assailants. Domestic violence is the most common cause of injuries among women, exceeding injuries caused by motor vehicle accidents and muggings combined. Despite the prevalence of domestic violence, victims of abuse often are not identified during physician visits. Caralis and Musialowski interviewed women attending ambulatory clinics at a Veterans Affairs Medical Center to obtain information about their experiences with domestic violence and their attitudes and expectations regarding medical care.

A total of 406 participants were interviewed by trained persons using a standardized 50-item questionnaire. The survey included questions about personal experiences with domestic violence, and preferences and expectations about physician screening for domestic violence and treatment of victims.

The mean age of the study participants was 50.4 years. Forty percent reported emotional or physical abuse by a partner at some time during their lives. Seven percent were in an abusive relationship at the time of the interview.

Most of the women believed that physicians should routinely screen for domestic violence in their patients; 85 percent “agreed” and 50 percent “strongly agreed” that routine screening for domestic violence should be incorporated into medical practice. Only 12 percent of the total group stated that their physicians had inquired about domestic violence, although 23 percent of the women who had been abused reported that physicians or nurses had asked them about abuse. Sixty-eight percent of the women “strongly agreed” that they would admit to experiencing domestic violence if their physicians asked them about it. Twenty percent of the victims said that their physicians, even when informed of abuse, did nothing with the information. The majority of the women believed that physicians should provide information concerning community and legal resources if violence affects their patients and should assist patients in finding protective services.

The authors conclude that women expect physicians to address the issue of domestic violence. They also expect physicians and other health care professionals to take an active role in providing services for victims and perpetrators of abuse. Women recognize that physicians and other professionals can work together to coordinate the range of community services that are available to victims of domestic violence

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