Family physicians' approach to wife abuse: a study of Ontario, Canada, practices

Approximately one in eight Canadian women is assaulted by a male partner during the course of their relationship. The objective of this research was to determine the perceptions of Ontario family physicians regarding their effectiveness in identifying and dealing with abused female patients.

A questionnaire was mailed to all family physicians in one urban and two rural Ontario communities. The questionnaire requested information about the physicians' perceptions regarding: 1) success in identifying wife abuse, 2) barriers to identifying wife abuse, and 3) the physician's role in management of abused patients.

The response rate was 82%, yielding a sample of 505 physicians. Respondents estimated that 14% to 17% of their female patients had been victims of abuse, but more than 70% of respondents believed that they identified fewer than 50% of such patients in their practices. The most common reasons cited for failing to detect abused women were patient unresponsiveness, lack of physician initiative, and infrequent visits by the patient. Respondents indicated that the most important role of a family physician in managing abused patients was to provide emotional support, inform patients about community services, and arrange referrals for those services.

Despite knowledge of its prevalence, physicians underdiagnose spouse abuse. This suggests a need for more physician education.