Vonkeman Janeske, Atkinson Paul, Fraser Jacqueline, McCloskey Rose, Boyle Adrian
Family Medicine, Dalhousie University, Saint John, CAN.
Emergency Medicine, Saint John Regional Hospital, Saint John, CAN.
Cureus. 2019 Dec 28;11(12):e6493. doi: 10.7759/cureus.6493.
Background Domestic violence rates in smaller cities have been reported to be some of the highest in Canada. It is highly likely that the staff at emergency departments (ED) will come in contact with victims of intimate partner violence in their daily practice. The purpose of this study is to better understand current practices for detecting intimate partner violence, staff awareness and knowledge regarding intimate partner violence, and barriers to questioning about intimate partner violence in the ED. Methods A standardized retrospective chart review captured domestic violence documentation rates in patients presenting to the ED, and a cross-sectional online survey was distributed to the ED staff. Results We found documentation about intimate partner violence in 4.64% of all included patient charts. No documentation was noted in the domestic violence field. Significantly, 16.4% of the ED staff reported never questioning female patients about intimate partner violence; 83.6% enquired when they thought it appropriate, and none asked routinely. None of the staff used a structured screening tool, and 81.8% of the ED staff had not received any formal training. Partner presence was the most common barrier to asking about intimate partner violence, followed by a lack of access to domestic violence management information, and a lack of knowledge regarding intimate partner violence. Conclusions Our findings suggest that the current documentation tools are not being properly utilized. Low rates of intimate partner violence documentation in high-risk patients and lack of education indicate that there is a need to improve current practices. In order to improve identification of this important problem, appropriate training and education about intimate partner/domestic violence are required to increase staff comfort as well as knowledge about available community resources for the victims.
背景 据报道,加拿大一些较小城市的家庭暴力发生率位居全国前列。急诊科工作人员在日常工作中极有可能接触到亲密伴侣暴力的受害者。本研究旨在更好地了解目前在急诊科检测亲密伴侣暴力的做法、工作人员对亲密伴侣暴力的认识和知识,以及在急诊科询问亲密伴侣暴力情况的障碍。方法 通过标准化的回顾性病历审查,统计到急诊科就诊患者中家庭暴力记录的发生率,并向急诊科工作人员发放横断面在线调查问卷。结果 在所有纳入研究的患者病历中,我们发现有4.64%记录了亲密伴侣暴力情况。家庭暴力领域未发现相关记录。值得注意的是,16.4%的急诊科工作人员表示从未询问过女性患者关于亲密伴侣暴力的情况;83.6%的工作人员在认为合适时会进行询问,且无人进行常规询问。没有工作人员使用结构化筛查工具,81.8%的急诊科工作人员未接受过任何正式培训。伴侣在场是询问亲密伴侣暴力情况最常见的障碍,其次是缺乏家庭暴力管理信息以及对亲密伴侣暴力缺乏了解。结论 我们的研究结果表明,目前的记录工具未得到妥善利用。高风险患者中亲密伴侣暴力记录率低以及缺乏相关教育表明,需要改进当前的做法。为了更好地识别这一重要问题,需要对亲密伴侣/家庭暴力进行适当培训和教育,以提高工作人员的舒适度,并增加他们对受害者可用社区资源的了解。