Prevalence of intimate partner violence and health implications for women using emergency departments and primary care clinics.

  • Kramer A
  • Lorenzon D
  • Mueller G
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OBJECTIVES: To determine prevalence of intimate partner violence (IPV) among women accessing health care, factors that influence rates of abuse, barriers to disclosure, and associated health problems and perceptions of safety.

METHODS: A convenience sample of women seeking health care completed 1268 anonymous surveys (75 in Spanish) while at 1 of 24 urban, suburban, or rural emergency departments or primary care clinics.

RESULTS: Of women in this study, 50-57% had experienced physical and/or emotional abuse and 26% reported sexual abuse in their lifetime. In the past year, 28% reported emotional abuse, 12% physical abuse, 6% severe physical abuse, and 4% sexual abuse. Logistic regression models found that younger, less-educated, less-affluent women presenting to urban emergency departments reported the highest rates of physical abuse. Although 83% welcomed abuse screening, only 25% ever had been asked and 86% would disclose abuse if asked directly, respectfully, and confidentially. Abused women reported significantly lower health status ratings than nonabused women (p < 0.001). Emotional abuse was as strongly associated with health problems as physical abuse. The majority (70-93%) of women with headaches, stomach problems, chronic pain, vaginal bleeding, substance abuse, depression, and suicidal thoughts had experienced lifetime physical/emotional abuse.

CONCLUSIONS: Women experience many forms of abuse and present to a wide range of health care settings. The striking prevalence of IPV and associated emotional/physical health problems challenges providers to routinely assess for abuse in ways that minimize barriers to disclosure and enhance the development of an effective plan of care based on a patient's abuse experience.

Author-supplied keywords

  • Adult
  • Attitude to Health
  • Battered Women
  • Battered Women: psychology
  • Battered Women: statistics & numerical data
  • Cross-Sectional Studies
  • Emergency Service, Hospital
  • Emergency Service, Hospital: statistics & numerica
  • Emergency Service, Hospital: utilization
  • Female
  • Health Status
  • Humans
  • Midwestern United States
  • Midwestern United States: epidemiology
  • Prevalence
  • Primary Health Care
  • Primary Health Care: statistics & numerical data
  • Primary Health Care: utilization
  • Psychophysiologic Disorders
  • Psychophysiologic Disorders: diagnosis
  • Psychophysiologic Disorders: epidemiology
  • Questionnaires
  • Spouse Abuse
  • Spouse Abuse: psychology
  • Spouse Abuse: statistics & numerical data
  • Time Factors
  • Women's Health

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  • Alice Kramer

  • Darcy Lorenzon

  • George Mueller

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