Detecting intimate partner abuse within clinical settings: self-report or an interview

Routine screening for intimate partner abuse (IPA) has been recommended within health-care settings. However, the instruments and methods that are most effective in detecting abuse continues to be debated in the literature.

To evaluate the effectiveness of two screening procedures/methods, a self-reporting questionnaire and an interview, in detecting women abuse within an emergency department (ED) and a high-risk prenatal care clinic (HRPCC). Comparison was made related to missing data based on the frequency of missing data.

Cross-sectional design was used in the study.

Data were collected at one time in 2006, over a period of 7 months, from 101 women seeking health-care services at an ED and 107 pregnant women in their first trimester attending a HRPCC.

Two methods were used, a self-reporting instrument and a face-to-face interview with a nurse or a midwife to compare the frequency of women's disclosure of abuse.

A variety of prior and current abuse experiences were disclosed by each method. The women however disclosed physical abuse more often in the face-to-face interview. The women at the ED disclosed emotional and sexual abuse by an intimate partner more often when using the self-reporting instrument; but the women at the HRPCC disclosed the same ratio of emotional and sexual abuse regardless of the method used. The face-to-face interview had fewer missing data regarding disclosure of abuse. Contradictory to what has previously been reported in the literature, there were no clear-cut results found regarding which of the methods were more effective in revealing abuse; rather, for some of the women, disclosure was based on a combination of the two methods used and the type of abuse inquired about.

Implications might focus on using different methods within different clinical settings, e.g. face-to-face interviews at an ED, but questionnaire(s) at a HRPCC; or by using the mixed methods approach within the same clinical setting. Such a decision should however be based on the purpose of screening for women abuse and on how and in what way clinicians and researchers would intervene with the women.