In a study of 2,005 well-educated, middle-class, Caucasian and African American women, published in the May 27 issue of the Archives of Internal Medicine, one in 10 reported histories of domestic violence and now suffer from neurological, gynecological, and stress-related problems at a rate 50 to 70 percent higher than never-abused women.
Symptoms among the abused women included headaches, back pain, sexually transmitted diseases, urinary infections, appetite loss, and abdominal pain. They also reported significantly more gynecological, chronic stress, and central nervous system problems.
"Injuries to the face, neck, and upper body are obvious indicators of abuse, but domestic violence also leads to long-term emotional and physical health consequences," according to lead author Jacquelyn C. Campbell, PhD, RN, the Anna D. Wolf Professor at Hopkins School of Nursing. "Such symptoms are not generally associated with domestic violence, and therefore questions about possible violence should be included in routine screening of all women."
"Health care professionals are becoming more aware of the immediate problems associated with abuse," says Campbell. "The next step is to expand this awareness to those problems that persist, develop over time, or linger after the abuse ends. We need to be on the lookout for those more subtle signals as well." Campbell says overlooking the possibility of abuse could result in prescribing a useless treatment. For example, recommending safe sex practices will not help a woman who is being sexually abused.
Study results also point to a need to screen for abuse regardless of a woman's socioeconomic status.
"Our sample represented a racially balanced and primarily highly educated group of middle-class, working women. One in 10 reported intimate partner violence," says Campbell. "The practitioner who feels it is necessary to screen for abuse only in low-income women could miss many higher income patients who are abused."
Campbell adds that health care professionals lack a standard set of signs, symptoms, and illnesses to signal current or prior incidents of domestic violence. "We hope this study will be useful towards the development of a standard compilation to use in routine universal screening to alert practitioners of possible abuse."
The study was funded by the United States Army. Other authors include Alison Snow Jones, PhD (Wake Forest University School of Medicine); Jacqueline Dienemann, PhD, RN (Georgetown University); Joan Kub, PhD, RN, Janet Schollenberger, MHS, (Johns Hopkins School of Nursing) Patricia O'Campo, PhD, and Andrea Carlson Gielen, PhD (Johns Hopkins School of Public Health); and Clifford Wynne, MD (Kaiser Permanente).
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