Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
School for Policy Studies, University of Bristol, Bristol, UK.
BMC Fam Pract. 2020 Jun 23;21(1):117. doi: 10.1186/s12875-020-01171-4.
Domestic violence and abuse (DVA) is common and damaging to health. UK national guidance advocates a multi-agency response to DVA, and domestic homicide reviews consistently recommend improved information-sharing between agencies. Identification of patients experiencing DVA in general practice may come from external information shared with the practice, such as police incident reports and multi-agency risk assessment conference (MARAC) reports. The aim of this study was to explore the views of general practitioners (GPs) and the police about sharing reports about DVA with GPs.
Qualitative semi-structured interviews were conducted with GPs, police staff and a partnership manager. Participants were located across England and Wales. Thematic analysis was undertaken.
Interviews were conducted with 23 GPs, six police staff and one former partnership manager. Experiences of information-sharing with GPs about DVA varied. Participants described the relevance and value of external reports to GPs to help address the health consequences of DVA and safeguard patients. They balanced competing priorities when managing this information in the electronic medical record, namely visibility to GPs versus the risk of unintended disclosure to patients. GPs also spoke of the judgements they made about exploring DVA with patients based on external reports, which varied between abusive and non-abusive adults and children. Some felt constrained by short general practice consultations. Some police and GPs reflected on a loss of control when information about DVA was shared between agencies, and the risk of unintended consequences. Both police and GPs highlighted the importance of clear information and a shared understanding about responsibility for action.
GPs regarded external reports about DVA as relevant to their role, but safely recording this information in the electronic medical record and using it to support patients required complex judgements. Both GPs and police staff emphasised the importance of clarity of information and responsibility for action when information was shared between agencies about patients affected by DVA.
家庭暴力和虐待（DVA）很常见，且对健康有害。英国国家指南提倡多机构应对 DVA，而家庭杀人审查报告一致建议改善机构间的信息共享。在一般实践中识别遭受 DVA 的患者可能来自与实践共享的外部信息，例如警方事件报告和多机构风险评估会议（MARAC）报告。本研究旨在探讨全科医生（GP）和警方对与 GP 共享有关 DVA 的报告的看法。
对全科医生、警察人员和合作伙伴经理进行了定性半结构化访谈。参与者遍布英格兰和威尔士。进行了主题分析。
对 23 名全科医生、6 名警察人员和一名前合作伙伴经理进行了访谈。与 GP 共享有关 DVA 的信息的经验各不相同。参与者描述了外部报告对 GP 的相关性和价值，以帮助解决 DVA 的健康后果并保护患者。他们在电子病历中管理此信息时平衡了竞争的优先事项，即 GP 的可见性与对患者无意披露的风险。GP 还谈到了根据外部报告对患者进行 DVA 调查的判断，这些判断在受虐待和不受虐待的成人和儿童之间有所不同。有些人感到受到 GP 短时间咨询的限制。一些警察和 GP 反思了当 DVA 信息在机构之间共享时失去控制的情况，以及意外后果的风险。警察和 GP 都强调了明确信息和对行动责任的共同理解的重要性。
GP 认为有关 DVA 的外部报告与其角色相关，但在电子病历中安全记录此信息并使用它来支持患者需要进行复杂的判断。GP 和警察人员都强调了在有关受 DVA 影响的患者的信息在机构之间共享时，信息的明确性和行动责任的重要性。
