Identifying domestic violence: cross sectional study in primary care

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Abstract
Objectives: To measure the prevalence of domestic violence among women attending general practice; test the association between experience of domestic violence and demographic factors; evaluate the extent of recording of domestic violence in records held by general practices; and assess acceptability to women of screening for domestic violence by general practitioners or practice nurses. Design: Self administered questionnaire survey. Review of medical records. Setting: General practices in Hackney, London. Participants: 1207 women (>15 years) attending selected practices. Main outcome measures: Prevalence of domestic violence against women. Association between demographic factors and domestic violence reported in questionnaire. Comparison of recording of domestic violence in medical records with that reported in questionnaire. Attitudes of women towards being questioned about domestic violence by general practitioners or practice nurses. Results: 425/1035 women (41%, 95% confidence interval 38% to 44%) had ever experienced physical violence from a partner or former partner and 160/949 (17%, 14% to 19%) had experienced it within the past year. Pregnancy in the past year was associated with an increased risk of current violence (adjusted odds ratio 2.11, 1.39 to 3.19). Physical violence was recorded in the medical records of 15/90 (17%) women who reported it on the questionnaire. At least 202/1010 (20%) women objected to screening for domestic violence. Conclusions: With the high prevalence of domestic violence, health professionals should maintain a high level of awareness of the possibility of domestic violence, especially affecting pregnant women, but the case for screening is not yet convincing. What is already known on this topic Domestic violence is associated with a wide range of health and social problems for women and their children Women experiencing violence are often not identified by health professionals in hospital settings Professional organisations and politicians are promoting a policy of screening for domestic violence What this study adds Over a third of women attending general practices had experienced physical violence from a male partner or former partner Most women who had experienced physical violence were not identified by general practitioners, according to data extracted from their medical records Women pregnant in the previous year were at high risk for current physical violence A substantial minority of women object to routine questioning about domestic violence