Intimate Partner Violence
Intimate Partner Violence (IPV)
Definition: Physical, sexual, or psychological harm by a current or former partner or spouse; occurs among heterosexual and same-sex couples
Epidemiology: Lifetime estimates for IPV in women= 22-39%
Sequelae: Untreated IPV results in many physical and psychological morbidities.
Pearl: Physicians should screen, document,intervene, and provide resources.
Screening
- U.S. Preventive Services Task Force: Level B recommendation for screening women of child-bearing age
- High certainty that the net benefit is moderate.
- Costs and potential harms of screening appear to be outweighed by potential for early intervention with screening.
- Interview patient alone. Frame: “Because violence is so common, we’re routinely asking our patients about their safety in their relationships.”
- Increase suspicion of abuse when overly protective partner, history inconsistent with injury, vague complaints, or pregnancy.
SAFE Questions
Stress/Safety: Do you feel safe in your relationship?
Afraid/Abused: Have you ever been in a relationship where you were threatened, hurt, or afraid?
Friend/Family: Are your friends aware you have been hurt?
Emergency Plan: Do you have a safe place to go and the resources you need in an emergency?
Document
Convey constructive messages:
- “Nobody deserves to be treated this way. You are not alone.”
- “I am concerned about your safety and health. There is help. I’d like you to speak with an advocate/counselor.”
Assess immediate safety for patient in ED.
Involve social work. Provide list of shelters, resources, and hotline.
Define safety plan for discharge.
Resources
- National Domestic Violence Hotline: 1-800-799-SAFE
- National Sexual Assault Hotline: 1-800-656-HOPE
- National Child Abuse Hotline: 1-800-4-A-CHILD (and contact local Child Protective Services)
