screening tools

Where should intimate partner violence screening be conducted?

• In a private setting, without the patient?s partner present.
• In all emergency, surgical, prenatal, primary care, pediatric, and mental health settings.

When should intimate partner violence screening be conducted?

• As part of routine health history.
• As part of the standard health assessment.
• During an initial visit.
• During every new patient encounter.
• During every periodic comprehensive health visit.

How should intimate partner violence screening be conducted?

• In a direct, non-judgmental manner.
• In private- it may be necessary to emphasize confidentiality as a standard procedure of interviewing patients alone.

Assure the patient of confidentiality:

• If the patient?s abusive partner is also your patient, clearly state that any information shared will not be disclosed to the partner.
• Determine your institution?s policy on reporting intimate partner violence and take this into consideration when discussing the issue.
• Assure the patient that information provided will be kept confidential, except of instance of child abuse, when reporting to the authorities is mandatory.

Frame the question:

• ?Because violence is so common in many people?s lives, I?ve begun to ask all my patients about it.?
• "I?m concerned that your symptoms may have been caused by someone hurting you.?
• "I don?t know if this is a problem for you, but many women I see as patients are dealing with abusive relationships. Some people are reluctant to bring it up, so I always ask the question.?

Ask Direct questions:

• ?Are you in a relationship with someone who physically hurts or threatens you??
• ?Have you ever been hit, kicked, or punched by your partner??
• ?Has your partner ever forced you to have sex when you didn?t want to or hurt you sexually??
• ?Do you feel safe at home??
• ?Do you ever feel afraid of your partner??

Ask about injuries:

• ?I notice you have a number of bruises (or other injury) Did someone do this to you??
• ?Did someone cause these injuries? Was it your partner or spouse??

Respond to disclosure:

• Allow the patient to talk about it.
• Listen non-judgmentally.
• Validate her experience by conveying affirming messages that demonstrate sensitivity and compassion.
• Provide referral and offer the patient the opportunity to call for community services or assistance while at the office.

Respond to denials:
If the patient denies abuse, but you still suspect it, let her know your concerns. Make sure you provide the patient with educational materials and referrals to community resources. Document your concerns in the medical chart.

Respond to an offended patient:
Although rare (most patients are appreciative), you could respond by saying: ?I?m sorry, I didn?t mean to offend you. Most patients won?t tell me unless I ask. I just want patients to know that this is a safe place to talk about abuse.?