Abuse victims prefer written disclosure in health care settings

[img_inline align=”right” src=”http://padnws01.mcmaster.ca/images/MacMillan-H2.jpg” caption=”Harriet MacMillan”]Women who have experienced domestic violence prefer to disclose this using a written questionnaire rather than tell health care providers face-to-face, according to a McMaster University research study published in the Aug. 2 issue of the Journal of the American Medical Association (JAMA).

And more women are willing to provide complete information using the written format, says principal investigator Harriet MacMillan, a professor in the departments of Psychiatry and Behavioural Neurosciences, and Pediatrics. In the project, two screening instruments were used in three different reporting methods to determine the optimal way to get women in health care settings to divulge their experience with violence by an intimate partner.

The three methods used were face-to-face interviews; a written, self-completed questionnaire and a computer-based, self-completed questionnaire. The two instruments being tested were the Partner Violence Screen (PVS) and the Woman Abuse Screening Tool (WAST).

Although the prevalence of reported abuse was roughly the same regardless of which screening tool was used, (ranging from about four to 17 per cent, depending on the type of health care setting) the face-to-face interview was the least preferred by the women taking part in the trial.

MacMillan said the results of this study are important for future research on whether routine screening in the health care setting for domestic violence is an effective way to deal with an issue that has gained recognition as a major public health problem.

It is also important for those in clinical settings to be aware that the face-to-face interview is the least preferred among women providing details about their situations.

The study also showed that there was less missing data from participants with the written questionnaire.

The research project took place from May 2004 to January 2005, at several Ontario locations, including family doctor practices, emergency departments and women's health clinics.

The effectiveness of each screening tool tested was gauged based on the prevalence of abuse in the previous 12 months, the extent of missing data and participant preference.

MacMillan said the results led to the decision to use a written screening approach in a follow-up study now underway that is examining whether screening in the health care setting for domestic violence has an impact on reducing the incidence of subsequent violence.

“It's important for us to know the best method of screening for violence to evaluate, as we try to determine whether such screening has an impact on women's lives,” said Dr. MacMillan. “If violence is being made known to health care providers, and they are acting on that information, we want to know if that is an effective way to reduce the future incidence of violence and improve the quality of life of victims.”