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Should health professionals screen women for domestic violence? : systematic review

By Jean Ramsay, Jo Richardson, Yvonne Carter, Leslie L. Davidson and Gene Feder

Abstract

Objective To assess the evidence for the acceptability\ud and effectiveness of screening women for domestic\ud violence in healthcare settings.\ud Design Systematic review of published quantitative\ud studies.\ud Search strategy Three electronic databases (Medline,\ud Embase, and CINAHL) were searched for articles\ud published in the English language up to February\ud 2001.\ud Included studies Surveys that elicited the attitudes of\ud women and health professionals on the screening of\ud women in health settings; comparative studies\ud conducted in healthcare settings that measured rates\ud of identification of domestic violence in the presence\ud and absence of screening; studies measuring\ud outcomes of interventions for women identified in\ud health settings who experience abuse from a male\ud partner or ex­partner compared with abused women\ud not receiving an intervention.\ud Results 20 papers met the inclusion criteria. In four\ud surveys, 43­85% of women respondents found\ud screening in healthcare settings acceptable. Two\ud surveys of health professionals' views found that two\ud thirds of physicians and almost half of emergency\ud department nurses were not in favour of screening. In\ud nine studies of screening compared with no\ud screening, most detected a greater proportion of\ud abused women identified by healthcare professionals.\ud Six studies of interventions used weak study designs\ud and gave inconsistent results. Other than increased\ud referral to outside agencies, little evidence exists for\ud changes in important outcomes such as decreased\ud exposure to violence. No studies measured quality of\ud life, mental health outcomes, or potential harm to\ud women from screening programmes.\ud Conclusion Although domestic violence is a common\ud problem with major health consequences for women,\ud implementation of screening programmes in\ud healthcare settings cannot be justified. Evidence of the\ud benefit of specific interventions and lack of harm from\ud screening is needed

Topics: RA
Publisher: BMJ Group
Year: 2002
OAI identifier: oai:wrap.warwick.ac.uk:4352

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