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Intimate Partner Violence Resources Differ Among EDs

Intimate partner violence (IPV) occurs in an estimated 2 million women in the United States each year and in up to 26% of American women over the course of their lifetime. IPV involves any pattern of assaultive and coercive behaviors, including physical injury, psychological abuse, and sexual assault. Other components of IPV include social isolation, stalking, deprivation, and intimidation or threats from someone who was or is in an intimate relationship with the victim. Studies indicate that IPV is more common among individuals visiting the ED for care. The prevalence of IPV in the ED in the past year ranges from 12% to 19% in published research. The estimated lifetime prevalence of IPV in the ED ranges from 44% to 54%. In 2004, the Joint Commission updated its basic standards for hospital policies and procedures to increase the identification of IPV within EDs and hospital-based ambulatory care centers. These standards are uniform for all hospitals but do not acknowledge the potential resource differences between rural and urban EDs. Geographic and economic barriers to seeking healthcare in rural areas are often greater than those of non-rural settings, and alternatives for follow-up care and referrals may be limited. Rural EDs Lagging in IPV Resource Availability My colleagues and I conducted a study that assessed differences in IPV resource availability between urban and rural EDs. Published in the May 2011 Western Journal of Emergency Medicine, the study examined results from standardized telephone interviews of ED directors and nurse managers on six IPV-related resources: 1) official screening policies 2) standardized screening tools 3) public displays regarding IPV 4) on-site advocacy 5) intervention checklists...

Detecting Intimate Partner Violence More Quickly

Published research indicates that nearly one-third of women reported that they were presently experiencing some form of intimate partner violence (IPV) when they were asked about these occurrences during an ED visit. When questioned about their past, nearly 50% of women reported being victims of IPV. In addition, other research has demonstrated that 56% of victimized female patients presenting to the ED also report perpetration behaviors. Studies that have focused on detecting perpetrators of IPV in the ED suggest that screening is effective, but few of these individuals are actually identified in medical settings despite frequently being in attendance. Testing a Shorter Screening Tool for IPV The gold standard for detecting perpetrators of IPV in the ED has historically been the 25-question Physical Abuse of Partner Scale (PAPS). Although the PAPS is an effective, validated questionnaire, the length of time needed to administer it is not practical for a short visit in the ED. In the February 2012 Journal of Emergency Medicine, my colleagues and I had a study published in which we developed a shorter IPV screening alternative to the PAPS. We developed the PErpetration RaPid Scale (PERPS) by validating a shortened version of the PAPS consisting of three questions: 1. Have you ever forced your partner to have sex or hurt your partner during sex? 2. Have you ever pushed or shoved or poked your partner violently? 3. Have you ever hit or punched your partner’s arms, body, head, or face? Unlike the PAPS, which uses a Likert scale for its 25 questions, PERPS has the potential to be administered more quickly because it uses only “yes/no”...
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