A survey of residents' attitudes and practices in screening for, managing, and documenting domestic violence.

OBJECTIVE

We conducted this study to identify residents' limitations in screening for, documenting, and managing domestic violence (DV) and to focus future educational interventions.

METHODS

We administered a detailed survey to 103 internal medicine residents from 4 university-affiliated programs to ascertain their attitudes about and practices in screening for, documenting, and managing DV.

RESULTS

Most residents agreed that DV is a significant health care problem (87%) and one in which physicians can intervene effectively (77%), yet 37% reported not screening for DV. Residents who said they do not screen reported a variety of mitigating factors, from uncertainty about how to screen for and manage DV, to fear of insulting or angering the patient. Eighty-two percent stated that they would document DV in the chart, but 51% had reasons for not documenting DV, ranging from fear that the patient's partner might harm the patient or the physician to concern that the patient may not be telling the truth. Fifty-seven percent of residents said they would ask about DV more often if state law mandated it. When asked to choose which management interventions were helpful or unhelpful, many residents made incorrect, potentially injurious choices.

CONCLUSION

Many residents reported beliefs and practices that could inhibit optimal care of DV victims. Educational interventions should be directed at remedying residents' gaps in knowledge and attitudes to improve screening for, documenting, and managing DV.