The Role of the Medical Professionals in Screening and Prevention

Because of the widespread impact of domestic violence, screening for domestic violence should be done routinely, at regular office visits, wellness/illness visits, and in the emergency department or urgent care centers for all female patients. How a medical professional screens for domestic violence can affect outcomes and the safety and comfort of patients. The following guidelines have been made available as a framework for screening for domestic violence.

Both victims and medical professionals have opened up about barriers to screening and disclosing domestic violence. This section will help you identify and overcome those barriers. The next section will provide you with a framework for screening patients for domestic violence.

What Barriers to Screening have been identified by Medical Professionals?

Click on each barrier to learn solutions.
  • Lack of Time

    While screening may take some time when done properly, the time it takes to express concern for your patient can help increase outcomes later. Patients can receive healthcare that addresses their physical health and prevents further injury or conditions related to domestic violence. Patients also feel that medical professionals who show concern are easier to talk to about health issues.

    How to overcome: Build in few extra minutes between visits and appointments to account for time to discuss violence.

  • Lack of Training

    While medical professionals may not be experts on domestic violence, they are able to use what they know about the public health crisis of domestic violence to help patients connect with advocates and agencies that can help them.

    How to overcome: Take opportunities to read new research on domestic violence (specifically in healthcare settings) and become more comfortable with the resources available in your community for patients in need. (View Citation)

  • Feeling Helpless or like There’s No Solution

    No one person can help someone who is a victim of domestic violence fully escape her situation. But providing support, resources, and showing concern for patients can empower them to get assistance from a domestic violence shelter, mental health counselor, or other resource.

    How to overcome: Complete the Domestic Violence training and the Screening Training. Take opportunities to read new research on domestic violence (specifically in healthcare settings) and become more comfortable with the resources available in your community for patients in need. Recognize the importance of being non-judgmental, supportive, and a good listener. (View Citation)

  • Fear of Offending

    While not all patients may be victims of domestic violence, asking patients about domestic violence while explaining the far reach of violence can help normalize the question and make victims and non-victims alike feel more comfortable.

    How to overcome: Explain to patients that because of the far reach of domestic violence, you ask all your patients, regardless of who they are. Domestic violence can affect anyone, regardless of their socio-economic status, age, race, culture, ethnicity, religion, gender, or sexual identity.
    (View Citation)

  • Unsure of Interventions

    No domestic violence victim has the same story as another. However, most victims will appreciate being provided with resources, like the number to a hotline or shelter, in case they decide they would like to use that resource.

    How to overcome: Be aware of the resources in your community and refer patients to those resources if you suspect or they disclose that they are in a domestic violence relationship or are in danger. (View Citation)

  • Bias or Ideas about Potential Victims

    Some medical professionals may be hesitant to ask about domestic violence because the patient may be similar to them in their career, socio-economic status, race, or be from the same neighborhood. But it’s important to remember that domestic violence occurs across all racial, cultural, age, and socio-economic boundaries.

    How to overcome: Remember that domestic violence happens in families of all races, cultures, ages, and socio-economic status. Some families may have access to more resources than others, but every woman should be supported. (View Citation)

  • Discomfort

    Domestic violence has often been treated as a private problem – but it is not. Domestic violence affects not only families, but entire communities and the nation as a whole.

    How to overcome: The impact and reach of domestic violence is so vast that it’s essential for medical professionals to get involved in screening and referrals. Do what you can to ease into the topic, but be direct, listen, and be supportive. (View Citation)

For more information on the barriers medical professionals and victims face when discussing domestic violence, see the Domestic Violence Training. You can also download the PDF below.



Barriers to Screening for Domestic Violence

Citations

Ellis, J. (1999). Barriers to effective screening for domestic violence by registered nurses in the emergency department. Critical Care Nursing Quarterly, 22 (1), 27-41.

Lapidus, G., Cooke, M., Gelven, E., Sherman, K., Duncan, M., & Banco, L. (2002). A statewide survey of domestic violence screening behaviors among pediatricians and family physicians. Archives of Pediatrics & Adolescent Medicine, 156, 332-336.

Owen-Smith, A., Hathaway, J., Roche, M., Gioiella, M., Whall-Strojwas, D., & Silverman, J. (2008). Screening for domestic violence in an oncology clinic: Barriers and potential solutions. Oncology Nursing Forum, 35, 625-633.

Elliot, L., Nerney, M., Jones, T., & Friedmann, P. (2002). Barriers to screening for domestic violence. Journal of General Internal Medicine, 17(2), 112-116.

Erikson, M., Hill, T., & Siegel, R. (2001). Barriers to domestic violence screening in the pediatric setting. Pediatrics, 108(1), 98-102.

Citations

McGrath, M., Bettacchi, A., Duffy, S., Peipert, J., Becker, B., & St. Angelo, L. (1997). Violence against women: Provider barriers to intervention in emergency departments. Academic Emergency Medicine, 4(4), 297-300.

Kulkarni, S., Bell, H., & Rhodes, D. (2012). Back to basics: Essential qualities of services for survivors of intimate partner violence. Violence Against Women, 18(1), 85-101.

Ellis, J. (1999). Barriers to effective screening for domestic violence by registered nurses in the emergency department. Critical Care Nursing Quarterly, 22 (1), 27-41.

Lapidus, G., Cooke, M., Gelven, E., Sherman, K., Duncan, M., & Banco, L. (2002). A statewide survey of domestic violence screening behaviors among pediatricians and family physicians. Archives of Pediatrics & Adolescent Medicine, 156, 332-336.

Citations

McGrath, M., Bettacchi, A., Duffy, S., Peipert, J., Becker, B., & St. Angelo, L. (1997). Violence against women: Provider barriers to intervention in emergency departments. Academic Emergency Medicine, 4(4), 297-300.

Citations

McGrath, M., Bettacchi, A., Duffy, S., Peipert, J., Becker, B., & St. Angelo, L. (1997). Violence against women: Provider barriers to intervention in emergency departments. Academic Emergency Medicine, 4(4), 297-300.

Lapidus, G., Cooke, M., Gelven, E., Sherman, K., Duncan, M., & Banco, L. (2002). A statewide survey of domestic violence screening behaviors among pediatricians and family physicians. Archives of Pediatrics & Adolescent Medicine, 156, 332-336.

Hathaway, J., Willis, G., & Zimmer, B. (2002). Listening to survivors’ voices: Addressing partner abuse in the health care setting. Violence Against Women, 8(6), 687-716.

Citations

McGrath, M., Bettacchi, A., Duffy, S., Peipert, J., Becker, B., & St. Angelo, L. (1997). Violence against women: Provider barriers to intervention in emergency departments. Academic Emergency Medicine, 4(4), 297-300.

Owen-Smith, A., Hathaway, J., Roche, M., Gioiella, M., Whall-Strojwas, D., & Silverman, J. (2008). Screening for domestic violence in an oncology clinic: Barriers and potential solutions. Oncology Nursing Forum, 35, 625-633.

  1. Renker, P., & Tonkin, P. (2006). Women’s views of prenatal violence screening: Acceptability and confidentiality issues. Obstetrics and Gynecology, 107(2). 348-354.