Intimate partner violence injuries in Australian orthopaedic clinics: a survey of clinician perspectives.

BACKGROUND

There is increasing recognition that intimate partner violence (IPV) is a global public health issue (1). In Australia, one in 6 women and one in 17 men experience IPV (2, 3). Musculoskeletal injuries are the second most common pathology suffered due to IPV, and previous studies have reported that as many as 1 in 50 patients present to orthopaedic outpatient clinics as a direct result of IPV (4, 5). Thus, this setting provides a unique opportunity to recognise patients at risk and facilitate intervention.

AIM

To investigate the perceptions and experiences of Australian orthopaedic clinicians regarding IPV injuries in outpatient clinics, and to identify barriers that prevent the detection of IPV in this setting.

METHODS

Orthopaedic surgeons and registrars were surveyed using a secure online platform distributed via the Australian Orthopaedic Association (AOA) from December 2023 to February 2024. Responses were analysed using Chi-square, Mann-Whitney U and Kruskal-Wallis tests with a 5% significance threshold.

RESULTS

Responses were provided by 101 fellowship trained surgeons or orthopaedic registrars. 92% either 'agree' or 'strongly agree' that IPV is a significant public health issue. Clinicians treated a mean of 5 patients per year (range 0-30) with reported IPV injuries, accounting for 0.4% (range 0-5.8%) of outpatient clinic presentations. Patients with IPV related injuries presented more frequently to public clinics than private rooms (p = 0.04). The most common perceived barriers to identifying and managing IPV are partners attending with patients (n = 84), time constraints (n = 75), lack of privacy (n = 58), and lack of social supports in clinic (n = 57).

CONCLUSION

Despite its prevalence in the wider community, few IPV-related injuries are identified or reported in Australian orthopaedic outpatient clinics, and many barriers exist. Understanding experiences and perceptions of this issue is key to improving our ability to provide care for this vulnerable population.