Injury PreventionHealth status and intimate partner violence: A cross-sectional study*,**,*
Introduction
In recent years, the consequences of intimate partner violence (IPV) have expanded from the sole purview of the criminal justice system to include the health care system. Nowhere is this more apparent than in an emergency department setting, which is often the primary medical contact for women assaulted by intimate partners. Historically, studies of emergency medicine and IPV have focused on determining the prevalence of IPV and the utility of screening tools.1, 2, 3, 4, 5
Recent studies have begun to identify risk factors associated with IPV.6, 7 Several studies have demonstrated that women who experience IPV are more likely to report using alcohol or illicit drugs,7, 8 attempting suicide, experiencing depression and chronic pain syndromes,9, 10 and childhood exposure to violence6, 9 than women who have not experienced IPV.9, 10 Most of these studies rely exclusively on self-reported data; these studies rarely include objective health measures to compare women who experience IPV with women who report no history of IPV.6 In addition, differences between the health profiles of women who have recently experienced IPV and the health profiles of women who have a more remote IPV history have not been extensively studied.
We conducted a cross-sectional study of women presenting to an ED to identify self-reported health and laboratory measures to define health profiles among women who have experienced recent (within the preceding 12 months) or remote (>12 months ago) incidents of intimate partner abuse and women who have not. We hypothesized that both self-reported and objective measures would indicate that women with any history of IPV would experience poorer health than women with no history of IPV. We further hypothesized that women experiencing recent IPV would have poorer health than women with a remote IPV history.
Section snippets
Materials and methods
We used a cross-sectional design. Participants were recruited from December 1996 to May 1997 in a large, urban ED in Albuquerque, NM, with approximately 55,000 patient visits per year. Thirty-five recruiting shifts were randomly assigned to trained recruiters using a computerized random block design to provide a balance of days and times.
All English-speaking female patients in noncritical condition between the ages of 18 and 50 years who presented to the ED during a recruiting shift were
Results
The Figure shows the number of women who presented to the ED during screening, as well as exclusion and refusal rates and participation rates by IPV status. Figure.Number of women presenting to ED and participation rates at each step of the project.LWBS,Left without being seen. P value for difference between exclusion rates was.28. P value for refusal rates was.15. P value for presenting for follow-up appointment was.10. P value for overall participation was.0095.
Discussion
To our knowledge, this is the first study of IPV in which women were recruited from an ED and then interviewed later in a controlled outpatient setting. This method permitted the collection of both self-reported and objective measures of participants’ health. The outpatient environment was controlled to be both quiet and private and allowed interviews of participants at a time and place that were separated from the health concern that brought them to the ED.
An interesting finding of this study
Acknowledgements
Author contributions: JB, LFG, LO, CC, SM, and DS participated in the study’s conception and design and in writing the manuscript. JB obtained research funding; JB, LO, and DS supervised the study. JB, LFG, CC, and SM all participated in patient recruitment; LFG and CC managed and analyzed the data. LFG, LO, and DS edited multiple drafts of the manuscript. LFG, LO, and DS take responsibility for the paper as a whole.
We thank the staff at the University of New Mexico General Clinical Research
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2009, Obstetrics and Gynecology Clinics of North AmericaCitation Excerpt :IPV can manifest as many different complaints or problems. Multiple physical complaints, chronic pain, depression, anxiety, substance abuse, or PTSD should prompt consideration of IPV, especially if the examination is inconsistent or treatment is not working.47–53 A positive answer to an IPV screen can feel like a crisis moment because of anxiety generated in a clinician.
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2020, Women's Health IssuesCitation Excerpt :The data from the present study indicate that from 2002 to 2015, 34 of every 10,000 ED visits were by women seeking care for IPV-related injuries. Although differences in methodology make comparisons of prevalence estimates difficult, the number of ED visits obtained in the present study is slightly higher than Btoush et al. (2009), who derived a national estimate of 21 per 10,000 visits between 1997 and 2001 using the NHAMCS dataset, but lower than that reported by prior studies that used population-based random telephone surveys (Black et al., 2011; Bonomi et al., 2006; Breiding, 2014), family practice clinics (Coker, Smith, Bethea, King, & McKeown, 2000; Hux, Schneider, & Bennett, 2009), and ED-based convenience samples (Brokaw, Fullerton-Gleason, Olson, Crandall, McLaughlin, & Sklar, 2002; Ernst, Nick, Weiss, Houry, & Mills, 1997). An analysis of secular trends indicated that there was a 4.3% increase in the proportion of IPV-related injuries across the 13-year period (Figure 1).
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Author contributions are provided at the end of this article.
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Supported in part by a National Institutes of Health Clinical Scholar Research Program grant No. 5MO1 RR00997.
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Address for reprints: Lynne Fullerton-Gleason, PhD, Department of Emergency Medicine, University of New Mexico Health Sciences Center, ACC 4W, Albuquerque, NM 87131;,505-272-5062, fax 505-272-6503, E-mail [email protected].