DrLooksAtXray700x_img_11072013 Health Care Providers

Health Care Providers

Domestic violence is both a personal and community health issue. Domestic violence affects all ages, encompassing child abuse, domestic violence and elder abuse.

1. As many as 40% of all women who seek care in hospital emergency rooms for violence-related injuries have been injured by a current or former partner.
2. Estimates of the prevalence of domestic violence against pregnant women range from 7% to 20%.
3. Children of mothers who experience prenatal physical domestic violence are at an increased risk of exhibiting aggressive, anxious, depressed or hyperactive behavior.
4. People and children with disabilities are significantly more likely to become victims of violence, abuse, or neglect than people without disabilities.

Cites: (1) T.M. Nappi et al. 2004. Brigham and Women's Hospital, Mary Horrigan Connors Center for Women's Health. Domestic Violence: A Guide to Screening and Intervention. 3. (2) Id. (3) Whitaker, RC, Orzol, SM, Kahn, RS. 2006. Maternal Mental Health, Substance Use, and Domestic Violence in the Year After Delivery and Subsequent Behavior Problems in Children at Age 3 Years. Archive of General Psychiatry. 63: 551-560. (4) http://www.cdc.gov/ncbddd/disabilityandhealth/relatedconditions.html.

PCADV and its member programs encourage health care providers to take steps to address domestic violence - and we are here to help. Call us at 800-932-4632.

  • Find brochures or palm cards for the waiting areas.
  • Request training for providers on healthcare and domestic violence.
  • Locate state and local resources for victims of domestic violence.
  • Contact our Health Education Specialist at 800-932-4632 to find a domestic violence medical advocate in your county for information, support and training.

Acute and Long-Term Consequences

Medical emergencies and ongoing abuse can lead to long-term health problems. Some issues include, but are not limited to, physical, emotional, and mental trauma; anxiety, depression and other mental health issues; neglect; special risks associated with pregnancy; child abuse; drug and alcohol addiction; rape, sexual coercion, and non-consensual pregnancies; sexually transmitted infections; traumatic brain injury; withholding, delaying, or misusing needed equipment and medication; and health issues that stem from homelessness or a significantly compromised quality of life.

Be a Pro-Active Provider

Health care providers can play a critical role in preventing and intervening in the dangerous, even fatal, patterns of domestic violence. The Pennsylvania Department of Welfare's 2010 Domestic Violence Task Force acknowledges:

The health care system has a vital role to play in bringing about social and institutional changes to end domestic violence.

A brief screening process for every patient regardless of gender, race, age, sexuality, religion, nationality, profession, or economic status can make a critical difference for adults, teens, and children who live with or are at risk for abuse.

Health care providers are usually the first and sometimes last contact a victim of violence encounters. Talking with patients about domestic violence provides a valuable opportunity for providers to learn about their experiences with abuse. Battered women report that one of the most important aspects of their interactions with a physician was being listened to about the abuse. July 2010 Report of the Pennsylvania Domestic Violence Task Force, Pennsylvania Department of Welfare,

The American College of Obstetricians and Gynecologists (ACOG) recommends that physicians screen ALL patients for intimate partner violence by making the following statement and asking these three simple questions:

"Because violence is so common in many women's lives and because there is help available for women being abused, I now ask every patient about domestic violence:
1. Within the past year -- or since you have been pregnant -- have you been hit, slapped, kicked or otherwise physically hurt by someone?
2. Are you in a relationship with a person who threatens or physically hurts you?
3. Has anyone forced you to have sexual activities that made you feel uncomfortable?"

Use the acronym RADAR, as explained below.
R = Routinely Screen Patients
A = Ask Direct Question - So the patient can answer "yes" or "no"
D = Document Your Findings
A = Assess Patient Safety
R = Review Options and Referrals

Documenting signs of abuse in a patient's medical record provides information for future visits that may cast light on chronic conditions and behavioral health issues.

Providers can refer patients who are abused by their intimate partners or family members to their local domestic violence program, hospital or clinic domestic violence medical advocate, to discuss safety planning and options.

One barrier to screening that practitioners report is a feeling that their intervention will not be effective or the patient will not leave the abuser. Leaving an abuser is a process, one in which a victim assesses safety, financial and legal resources, timing, family and other support before successfully separating. A year after separating finds most victims safer, but retaliatory violence (even homicide) is a documented concern. Education about abusers' behavior, as well as training on recognizing, screening and appropriately referring patients for domestic violence, help to boost staff confidence in their interventions.

PCADV offers a Health Care Provider Training Evaluation Tool Kit for those who would like to assess training needs in the area of domestic violence.

Trauma-Informed Approach

A trauma-informed model for health care services acknowledges the complex and overlapping circumstances in the lives of many patients, and PCADV supports this methodology as the Best Practices approach.

The National Center on Domestic Violence, Trauma and Mental Health has information and technical assistance for working with those who live with intimate partner, family, or dating abuse.

PCADV Works to Assist Providers to Care for Families Affected by Violence

  • PCADV is an active supporter of legislation to protect women's and children's healthcare options.
  • PCADV serves on the Pennsylvania Department of Welfare Domestic Violence Task Force with other statewide entities to develop a coordinated, integrated response to domestic violence in the Commonwealth.
  • PCADV domestic violence medical advocates provide technical assistance and training to healthcare providers helping domestic violence victims and their families. To find a medical advocate near you, call 800-932-4632.
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