Chau Courtney A, Singh Vijay, Lutnick Alexandra, Lesser Mary N R
Icahn School of Medicine at Mount Sinai, New York, NY.
University of Michigan Medical School Departments of Internal Medicine, Emergency Medicine, and Family Medicine, Ann Arbor, MI.
PRiMER. 2025 Apr 24;9:14. doi: 10.22454/PRiMER.2025.584466. eCollection 2025.
While guidelines exist for physicians to identify and respond to patients experiencing intimate partner violence (IPV), no studies describe physician practices of making mandated reports, advising patients about confidentiality limitations, or conducting homicide risk assessment. This pilot study aimed to explore current physician responses to patient disclosure of experiencing IPV.
We sent interview invitations from March to August 2022 to 11 US national medical societies and 118 state chapters for family medicine, general internal medicine, obstetrics and gynecology, emergency medicine, and plastic surgery. We conducted semi-structured qualitative online interviews that were recorded and transcribed. We conducted a thematic analysis to determine codes and themes.
Participants consisted of ten female and three male physicians with a median of 16 years in practice. Analysis revealed two themes based on self-reported knowledge and actions: (1) limited knowledge and use of mandatory reporting and risk assessment, and (2) reliance on team members due to limited protocol awareness and time. Most participants did not recall reporting requirements, and few physicians described reporting IPV to law enforcement, advising patients of confidentiality limitations, or conducting risk assessments. As a result of time barriers and limited expertise about protocols and resources, participants relied on social work and nursing team members to respond to IPV.
Physicians in this sample describe limited knowledge and use of mandatory reporting and safety assessment. These limitations can be further investigated in larger studies to determine the need for trainings that include reporting requirements and for developing IPV response protocols.
虽然有指南指导医生识别并应对遭受亲密伴侣暴力(IPV)的患者,但尚无研究描述医生进行强制报告、告知患者保密限制或进行杀人风险评估的做法。这项试点研究旨在探索医生目前对患者披露遭受IPV情况的应对方式。
2022年3月至8月,我们向美国11个全国性医学协会以及家庭医学、普通内科、妇产科、急诊医学和整形外科的118个州分会发出了访谈邀请。我们进行了半结构化定性在线访谈,并进行录音和转录。我们进行了主题分析以确定编码和主题。
参与者包括10名女医生和3名男医生,从业时间中位数为16年。分析基于自我报告的知识和行动揭示了两个主题:(1)对强制报告和风险评估的知识和使用有限,(2)由于对协议的认识有限和时间限制而依赖团队成员。大多数参与者不记得报告要求,很少有医生描述向执法部门报告IPV、告知患者保密限制或进行风险评估。由于时间障碍以及对协议和资源的专业知识有限,参与者依赖社会工作和护理团队成员来应对IPV。
该样本中的医生描述了对强制报告和安全评估的知识和使用有限。这些限制可在更大规模的研究中进一步调查,以确定是否需要开展包括报告要求的培训以及制定IPV应对协议。