Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America.
Department of Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America.
PLoS One. 2023 Apr 24;18(4):e0284194. doi: 10.1371/journal.pone.0284194. eCollection 2023.
Emergency Department (ED) screening for intimate partner violence (IPV) is typically nursing-initiated, often with visitors present. Since the onset of the COVID-19 pandemic, we have seen both an increase in societal stress, a known exacerbator of IPV, and the implementation of visitor restriction policies. This combination presents the need for enhanced IPV screening and the opportunity to perform screening in a controlled, patient-only environment. Our goal was to evaluate the frequency of nurse-initiated screening for IPV prior to and during the early months of the COVID-19 pandemic as well as the frequency of positive screens for IPV.
We conducted a retrospective cross-sectional study evaluating all adults (age >18 years) presenting to a tertiary care center ED. Patients were identified as presenting prior to the COVID-19 pandemic (June 1, 2019 to August 31, 2019) and after the COVID-19 visitor restriction policies (June 1, 2020 to August 31, 2020). Descriptive statistics were performed using chi-square and t-tests compared the demographic variables. Chi-square was used for a bivariate analysis of our primary outcomes (IPV screening performed and screening positive for IPV). Further analysis was done using a binary logistic regression model adjusting for the demographic characteristics.
Both the odds of nursing-initiated IPV screening and the odds of verbally screening positive for IPV significantly increased (OR 1.509, 95% CI 1.432-1.600) and (OR 1.375, 95% CI 1.126-1.681) respectively following the implementation of COVID-19 visitor restriction policies.
These findings suggest that nurse-initiated IPV screening should continue to be performed with the patient privately, even after COVID-19 related ED visitor restrictions are removed. These findings also support the hypothesis that the stress related to COVID-19 is contributing to a rise in IPV.
急诊科(ED)对亲密伴侣暴力(IPV)的筛查通常由护士发起,通常有访客在场。自 COVID-19 大流行开始以来,我们不仅看到了社会压力的增加,这是 IPV 的已知加剧因素,还看到了访客限制政策的实施。这种组合需要加强 IPV 筛查,并提供在患者单独环境中进行筛查的机会。我们的目标是评估 COVID-19 大流行之前和早期期间护士主动筛查 IPV 的频率,以及 IPV 阳性筛查的频率。
我们进行了一项回顾性横断面研究,评估了所有到三级护理中心 ED 就诊的成年人(年龄> 18 岁)。患者被确定为在 COVID-19 大流行之前(2019 年 6 月 1 日至 2019 年 8 月 31 日)和 COVID-19 访客限制政策之后(2020 年 6 月 1 日至 2020 年 8 月 31 日)就诊。使用卡方检验和 t 检验进行描述性统计,比较人口统计学变量。使用卡方检验对我们的主要结果(进行的 IPV 筛查和 IPV 筛查阳性)进行双变量分析。使用二元逻辑回归模型进一步分析,调整人口统计学特征。
在实施 COVID-19 访客限制政策后,护士主动进行 IPV 筛查的可能性和口头筛查阳性的可能性均显著增加(OR 1.509,95%CI 1.432-1.600)和(OR 1.375,95%CI 1.126-1.681)。
这些发现表明,即使在 COVID-19 相关的 ED 访客限制被取消后,也应继续私下对患者进行护士主动进行 IPV 筛查。这些发现还支持 COVID-19 相关压力导致 IPV 增加的假设。