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

December 6, 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: Doctors urged to make public commitment to talk to patients about guns and gun safety

Related Stories

Doctors urged to make public commitment to talk to patients about guns and gun safety

October 17, 2017
As guardians of health and gatekeepers to the world of medicine, primary care doctors are expected to plunge dauntlessly into the most delicate topics with their patients. Now, in the wake of the worst mass shooting in recent ...

Inexplicable spasms can now be explained with hormones

November 3, 2017
In Denmark, as many as 2,000 people - in particular women - suffer from spasms which are similar to epileptic seizures, but which cannot be measured, prevented, treated or explained. Until now, as with the publication of ...

Predictive models could save lives in rampant opioid crisis

October 27, 2017
Before Northeastern professor James Benneyan described his research, he gave a stark reminder of the opioid epidemic it aims to address.

Immigrant parents report fewer adverse childhood experiences than US-born parents

September 15, 2017
A new study found immigrants reported fewer potentially health-harming adverse childhood experiences, such as abuse, violence, or divorce, than native-born Americans. The findings, which will be highlighted in an abstract ...

Assessment tools, relationships key to addressing child trauma

September 8, 2017
Two new studies led by researchers at the Johns Hopkins Bloomberg School of Public Health suggest that the bevy of tools available to assess and address childhood adversity and trauma, as well as the interconnected webs of ...

Firearm-related injuries account for $2.8 billion on emergency room and inpatient charges each year

October 2, 2017
A new Johns Hopkins study of more than 704,000 people who arrived alive at a United States emergency room for treatment of a firearm-related injury between 2006 and 2014 finds decreasing incidence of such injury in some age ...

Recommended for you

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

1 comment

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

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.