Finding the right words: Provider-patient discussions can help domestic violence victims speak up

Dec 06, 2007

Researchers at University of Pennsylvania School of Medicine and other sites have found that doctors and other health care providers can better their chances of identifying and helping victims of domestic violence by changing the way they ask patients questions.

In a large study recently published in the Annals of Internal Medicine, researchers found a number of communication pitfalls when emergency care providers discussed domestic violence with patients. Some examples: Providers often stumbled over their words, failed to acknowledge a disclosure of abuse or abruptly changed the subject. Occasionally, they screened for abuse in the presence of the woman’s partner.

The study also revealed several best practices for communications. Follow-up questions and open-ended queries, for instance, were found to be helpful in prompting patients to disclose abuse. Patients also tended to open up to providers who showed empathy and concern or those who followed up on non-medical “clues” raised by patients, such when the patient talked about “stress.”

“We found that probing – asking even one more question – was associated with almost three times the rate of patient disclosure of experiences with abuse,” says lead author Karin V. Rhodes, MD, MS, Director of the Division of Health Policy Research in Penn’s Department of Emergency Medicine.

Previous studies showed that patients can be hesitant to disclose their abuse experiences to doctors, but information was scarce about why communication breaks down. To get clues into what happens during these private talks, investigators audiotaped 293 emergency room interactions that included a discussion of domestic violence. Seventy-seven patients disclosed experience with domestic violence during the interviews. Researchers identified several strategies that seemed to prompt more disclosure of abuse, highlighting the need to ask open-ended questions that didn’t use phrases like “victim” or “domestic violence,” which require the woman to view herself as a victim. Re-framed queries such as “Has anyone ever treated you badly or made you do things you don’t want to do"” or “Is there anyone you are afraid of"” tended to elicit disclosures, as did asking empathetic follow-up questions when patients mentioned other psychosocial problems.

The investigators pointed out that while better communication strategies were likely to open the door to meaningful conversations about abuse, patients appreciated being asked about the issue even when the provider asked about abuse in an awkward manner or stumbled over their words. Patients were more likely to rate their satisfaction with the visit as very high if there was any mention of the topic of domestic violence, even if they did not disclose abuse.

The research also revealed problems with provider action once disclosures are made. Less than a quarter of women who revealed abuse were referred to legal or counseling services, and providers generally failed to document domestic violence in the medical record -- something that can be helpful if an abused woman ultimately files criminal charges against her partner or seeks protection in civil court. These lapses occurred despite annual domestic violence education programs in each department studied and each provider’s awareness that they were being taped.

Source: University of Pennsylvania School of Medicine

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

add to favorites email to friend print save as pdf

Related Stories

Sea Shepherd catches Japanese fleet, four whales dead

Jan 06, 2014

Militant anti-whaling activists Sea Shepherd said they had zeroed in on a Japanese fleet Monday and captured evidence that four whales had been slaughtered, alleging the ships were found inside a Southern ...

Austria probes gruesome fate of Nazi-era disabled

Oct 19, 2012

(AP)—Forensic crews scraping away dirt from the remains of the Nazi-era psychiatric patients were puzzled: The skeletal fingers were entwined in rosary beads. Why, the experts wondered, would the Nazis—who ...

Indian youth suicide crisis baffles

Mar 21, 2011

(AP) -- Chelle Rose Follette fashioned a noose with her pajamas, tying one end to a closet rod and the other around her neck. When her mother entered the bedroom to put away laundry, she found the 13-year-old ...

Recommended for you

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

digitalinfos113
not rated yet Jul 22, 2008
Domestic voilence victims are not eligible for such kind of behaviour. They have to change their mind don't do so.
__________
Addiction Recovery Pennsylvania
Addiction Recovery Pennsylvania
Addiction Recovery Pennsylvania
Addiction Recovery Pennsylvania

More news stories

Teachers' scare tactics may lead to lower exam scores

As the school year winds down and final exams loom, teachers may want to avoid reminding students of the bad consequences of failing a test because doing so could lead to lower scores, according to new research published ...