Domestic violence: prevalence and detection in a family medicine residency clinic

This study was designed to investigate the detection rate of domestic violence by resident physicians in a community-based, primary care training program. Baseline information on detection rates was gathered from residents in the prestudy phase and was compared with data from the 6-month investigation phase of the study, during which a self-administered pencil-and-paper questionnaire on domestic violence was provided to patients and residents. The nursing staff screened new female patients and established patients returning for annual physical examinations. Patients older than 18 years were asked to complete a four-question survey. The examining resident physicians then reviewed the questionnaire answers with patients. During the 6-month prestudy phase, only 7 of 136 patients (5.1%) were determined to be in current (2.9%) or past (2.2%) abusive relationships. Of the 52 patients who completed the investigation phase of the study, 25 (48.1%) reported a lifetime history of abuse, with 9.6% of patients reporting current abuse and 38.5% reporting past abuse. There was a statistical difference regarding history of abuse and lifetime incidence of abuse between the control and study groups. The authors found that routine screening with a few questions could significantly increase detection of domestic violence and enable victims to begin to address their problems. This study has implications for continuing medical education programs as well as residency training programs.