Risk indicators to identify intimate partner violence in the emergency department

Intimate partner violence against women is prevalent and is associated with poor health outcomes. Understanding indicators of exposure to intimate partner violence can assist health care professionals to identify and respond to abused women. This study was undertaken to determine the strength of association between selected evidence-based risk indicators and exposure to intimate partner violence.

In this cross-sectional study of 768 English-speaking women aged 18-64 years who presented to 2 emergency departments in Ontario, Canada, participants answered questions about risk indicators and completed the Composite Abuse Scale to determine their exposure to intimate partner violence in the past year.

Intimate partner violence was significantly associated with being separated, in a common-law relationship or single (odds ratio [OR] = 2.08, 95% confidence interval [CI] 1.17-3.71); scoring positive for depression (OR = 4.26, 95% CI 2.11-8.60) or somatic symptoms (OR = 4.09, 95% CI 2.18-7.67); having a male partner who was employed less than part time (OR = 5.12, 95% CI 2.46-10.64), or having a partner with an alcohol (OR = 4.36, 95% CI 2.16-8.81) or drug problem (OR = 4.63, 95% CI 1.89-11.38). Each unit increase in the number of indicators corresponded to a four-fold increase in the risk of intimate partner violence (OR = 3.92, 95% CI 3.06-5.02); women with 3 or more indicators had a greater than 50% probability of a positive score on the Composite Abuse Scale. Intimate partner violence was not associated with pregnancy status.

Specific characteristics of male partners, relationships and women's mental health are significantly related to exposure to intimate partner violence in the past year. Identification of these indicators has implications for the clinical care of women who present to health care settings.