367 research outputs found
Sharing information about domestic violence and abuse in healthcare:an analysis of English guidance and recommendations for good practice
BACKGROUND: Over two million adults experience domestic violence and abuse (DVA) in England and Wales each year. Domestic homicide reviews often show that health services have frequent contact with victims and perpetrators, but healthcare professionals (HCPs) do not share information related to DVA across healthcare settings and with other agencies or services. AIM: We aimed to analyse and highlight the commonalities, inconsistencies, gaps and ambiguities in English guidance for HCPs around medical confidentiality, information sharing or DVA specifically. SETTING: The English National Health Service. DESIGN AND METHOD: We conducted a desk-based review, adopting the READ approach to document analysis. This approach is a method of qualitative health policy research and involves four steps for gathering, and extracting information from, documents. Its four steps are: (1) Ready your materials, (2) Extract data, (3) Analyse data and (4) Distill your findings. Documents were identified by searching websites of national bodies in England that guide and regulate clinical practice and by backwards citation-searching documents we identified initially. RESULTS: We found 13 documents that guide practice. The documents provided guidance on (1) sharing information without consent, (2) sharing with or for multiagency risk assessment conferences (MARACs), (3) sharing for formal safeguarding and (4) sharing within the health service. Key findings were that guidance documents for HCPs emphasise that sharing information without consent can happen in only exceptional circumstances; documents are inconsistent, contradictory and ambiguous; and none of the documents, except one safeguarding guide, mention how coercive control can influence patients’ free decisions. CONCLUSIONS: Guidance for HCPs on sharing information about DVA is numerous, inconsistent, ambiguous and lacking in detail, highlighting a need for coherent recommendations for cross-speciality clinical practice. Recommendations should reflect an understanding of the manifestations, dynamics and effects of DVA, particularly coercive control
Should health professionals screen women for domestic violence? : systematic review
Objective To assess the evidence for the acceptability
and effectiveness of screening women for domestic
violence in healthcare settings.
Design Systematic review of published quantitative
studies.
Search strategy Three electronic databases (Medline,
Embase, and CINAHL) were searched for articles
published in the English language up to February
2001.
Included studies Surveys that elicited the attitudes of
women and health professionals on the screening of
women in health settings; comparative studies
conducted in healthcare settings that measured rates
of identification of domestic violence in the presence
and absence of screening; studies measuring
outcomes of interventions for women identified in
health settings who experience abuse from a male
partner or expartner compared with abused women
not receiving an intervention.
Results 20 papers met the inclusion criteria. In four
surveys, 4385% of women respondents found
screening in healthcare settings acceptable. Two
surveys of health professionals' views found that two
thirds of physicians and almost half of emergency
department nurses were not in favour of screening. In
nine studies of screening compared with no
screening, most detected a greater proportion of
abused women identified by healthcare professionals.
Six studies of interventions used weak study designs
and gave inconsistent results. Other than increased
referral to outside agencies, little evidence exists for
changes in important outcomes such as decreased
exposure to violence. No studies measured quality of
life, mental health outcomes, or potential harm to
women from screening programmes.
Conclusion Although domestic violence is a common
problem with major health consequences for women,
implementation of screening programmes in
healthcare settings cannot be justified. Evidence of the
benefit of specific interventions and lack of harm from
screening is needed
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