Abuse and Violence: Drawing up an Anamnesis Questionnaire for Use in Clinical Practice

Abstract

The influence of abuse and violence has an undisputed effect on health. The first contact in any health system is the family doctor, whose training leaves her uncertain how to proceed in this context and the problem remains how to determine which patient should be referred to which resource. At Innsbruck Medical University (MUI) a gendered anamnesis questionnaire is being drawn up. It contains a section on sexuality and one on abuse and violence and after approval by the Ethics Committee was tested in up to 500 female patients at theWomen's Health Out-Patient Clinic. The first partial evaluation is presented here. The questionnaire was applied in female patients at the Women's Health Center, who were also asked if they wanted to fill out the sections on abuse and violence. Of the patients 155 with a mean age of 58.5 years consented. They were asked whether they had ever been asked in a medical setting if they had been the victim of abuse or violence: 127 (81.9%) replied Never. In an open-ended question they were asked if they had ever been the victim of violence, whether physical, emotional or sexual, including as a child or adolescent. Of the 155 patients, 56 (36.1%) replied they had been subject to physical violence, 59 (38.1%) emotional violence and 47 (30.3%) sexual violence; multiple replies were possible. In total 99 (63.9%) of the respondents stated they had been the victim of violence. They were also asked if they preferred not to talk about the subject in future; 142 (91.6%) replied No. When asked whether they expected doctors to offer resources in this context in future, 75 (48.4%) replied Yes; whether the subject should be broached openly and directly, 95 (61.3%) replied Yes; whether they preferred to be asked questions about the subject that have to be answered with yes or no, 138 (89.0%) replied No. Multiple responses were possible. Using this questionnaire it was possible to ask almost all patients on this topic and by asking the question openly learn of events going back to childhood, some of which had never before been reported. Designed like a medical history questionnaire, it was considerably easier for doctors to use to broach the subject and ask questions. After evaluating, further adaptations will be made to permit this questionnaire to be included in the typical anamnesis questionnaire used at the MUI clinics and to be able to offer it to external healthcare practitioners.