Domestic violence in a primary care setting. Patterns and prevalence

To determine the prevalence of domestic violence among women patients in a primary care setting, the types of violence experienced by each woman, and the reasons for their visit to the family physician.

Structured interviews with all consecutive, consenting women patients scheduled for morning appointments between July 26 and August 13, 1993.

A community-based family practice residency outpatient clinic in a midwestern city with a population of 85,000.

Of the 42 women interviewed, 45% reported experiencing physical, social, and/or emotional violence in their relationships. Thirty-six percent reported being physically battered during their lifetimes; 12% reported being currently involved in a battering relationship. Relationships and patterns between various types of violence were evident. Sixty-two percent of the women who had experienced slapping and hitting (moderate abuse) also experienced punching and kicking (severe violence), some of which included sexual violence and weapon use. Women who were sexually abused were also likely to be emotionally abused (r = .66; P < .001), and women who were socially abused were also likely to be severely battered (r = .60; P < .005). None of the currently battered women was being seen for routine health maintenance reasons, but presented instead with specific complaints such as neck stiffness and migraine headache.

Domestic violence is very prevalent among women patients in primary care settings and involves predictable patterns of injury. Physicians should routinely assess for violence at all types of visits, educate patients about violence, and work to prevent the violence that occurs in abusive relationships.