Training in screening techniques increases providers' sense of efficacy to help domestic violence victims and increases such screening
WASHINGTON -- Research has shown that the prevalence of people, particularly women, being beaten by their partners is high and that such victims are frequent users of medical services. For example, recent studies have shown that the incidence of women seeking care for a domestic violence injury in primary care medical settings ranges between 17 and 25 percent and between 22 and 35 percent in hospital emergency rooms. However, additional research suggests that these women are often not identified as partner abuse victims and are not provided appropriate services based upon their unique needs.
A new study, being presented today at the 108th Annual Convention of the American Psychological Association (APA), has found that although medical delivery settings provide ample opportunity for domestic violence victims to be identified and assisted, medical personnel often fail to screen for domestic violence or make appropriate referrals because doctors and nurses aren't confident in their ability to intervene or provide appropriate help to victims. Other barriers to screening identified by the study were often specific to the individual hospital facilities; lack of private rooms in the emergency department, for example.
Psychologists L. Kevin Hamberger, Ph.D., of the Medical College of Wisconsin, and Deb Pape, Ph.D., and Debbie Minsky, M.S.W., of All Saints Health Care Systems, Inc., Racine, WI, and their co-authors Clare Guse, Jennifer Boerger, and Christine Folsom, measured the amount of training in domestic violence intervention provided to 752 health care professionals in two hospitals in a midsize Midwestern city.
Through the use of a survey, the Health Care Provider Survey on Intimate Partner Violence, the health care providers (including doctors, nurses, certified medical assistants, radiology technicians, laboratory technicians, and social workers) were asked about the amount of training they had received, whether they routinely asked patients about violence in their relationships, and what their sense of efficacy was in screening for domestic violence.
Forty-eight percent of the study participants reported some prior type of domestic violence intervention training, and 25 percent reported having identified a victim of partner violence in the past year. But, this and other studies have also identified serious barriers to intervention that health providers feel when confronted with a situation involving battering.
Based on their study and earlier research, which shows that medical personal who have received training in how to screen for domestic violence and how to provide help to its victims are much more likely to ask patients about violence in their relationships, the authors recommend that all health care providers receive partner violence education designed to increase the providers' sense of efficacy to identify and help victims of partner violence.
"Providing trainees (medical personnel) with didactic information about domestic violence and the health care provider's role in intervention and prevention, together with role modeling and skill rehearsal, should result in increases in perceived judgments of self-efficacy to screen and help battered victims," conclude the authors.
But, the authors also emphasized that "one size training will not fit all". Their survey shows that different medical personnel are going to need different training, most often dependent on their previous training and experience with domestic violence victims.
Presentation: "Evaluation of Domestic Violence Training Programs for Health Care Professionals," L. Kevin Hamberger, Ph.D., Medical College of Wisconsin, Debbie Minsky, M.S.W., St. Luke's Hospital, Racine, WI. Session 4048:. Monday, August 7, 9:00-9:50 AM, Washington Convention Center, Meeting Room 28.
L. Kevin Hamberger, Ph.D., can be reached at his Medical College of Wisconsin office at 262-638-9600 or lkh@post.its.mcw.edu.
(Full text of the article is available from the APA Public Affairs Office)
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