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Screening for abuse in ER not a danger to victims

Wednesday, April 16, 2008
By Amy Norton

NEW YORK (Reuters Health) - Despite some concerns to the contrary, screening emergency room patients for domestic abuse does not seem to put victims at risk of more violence, a study suggests.

Researchers found that a computerized system for screening ER patients for intimate-partner violence did not endanger victims either in the hospital or after they went home.

The study found no incidents where victims' partners got in the way of their screening while in the ER. Victims also did not report escalating abuse or injuries in the week following the ER visit, according to findings published in the Annals of Emergency Medicine.

Moreover, the researchers found, more than one third of abuse victims said they had sought help based on the information they had received in the ER.

"I think our study supports screening as a safe and effective tool for domestic violence," lead researcher Dr. Debra Houry, of Emory University in Atlanta, told Reuters Health.

As it stands, certain medical groups, like the American Medical Association, recommend routine screening for domestic violence, but in most cases, ER patients are not asked about abuse unless a doctor suspects it.

Even in cases where a patient has a suspicious injury, Houry noted, a doctor may not associate it with domestic abuse, or may be uncomfortable bringing up the question.

For their study, Houry and her colleagues looked at the effects of a computerized screening system in a large, urban hospital ER. Of 2,134 patients who completed the questionnaire, one quarter said they had been abused by an intimate partner in the past year.

According to the researchers, there were no instances where an abuse victim's safety was threatened while completing the screening. In interviews with victims one week later, the researchers found no evidence that the domestic violence had worsened; the same was true when patients were interviewed again after three months.

All of the patients who reported abuse during their ER screening were given a list of shelters, legal services, abuse hotlines and other community resources. When they were interviewed at the three-month mark, 35 percent said they had contacted at least one of those resources.

Houry pointed out that the study was conducted in an inner-city ER, and it is hard to say whether routine abuse screening in other settings would have similar results.

She added, however, that there are high rates of unrecognized abuse among ER patients, and centers should consider screening for it. A computerized system like the one used in this study, Houry noted, can both take the "onus" off the ER staff and make patients more comfortable about disclosing any abuse.

SOURCE: Annals of Emergency Medicine, April 2008
 
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