Should women be screened for domestic violence?

Over a third of women attending general practices have experienced physical violence, but doctors and nurses rarely ask about it. Researchers in this week’s BMJ ask:

Should women be screened for domestic violence when they visit their general practitioner?
Is there a high risk group of women for whom screening might be more appropriate?
Is screening acceptable to women?

A sample of women visiting 13 general practices in Hackney, east London were surveyed about different aspects of domestic violence. Of 1,035 women, 41% had experienced physical violence from a partner or former partner. Yet, for most of these women, definite or suspected domestic violence was not recorded in their medical notes.

Pregnancy within the past 12 months doubled the risk of physical violence, suggesting that pregnant women are at high risk and that screening could be more appropriate for this group of women than for other groups, say the authors.

One in five women objected to routine questioning about domestic violence. This limited acceptability, and the absence of evidence of benefit to women from screening for domestic violence, means the case for screening is not convincing and its introduction would be premature, say the authors.

In the meantime, health professionals should maintain a high level of awareness of the possibility of domestic violence, especially in pregnant women, they conclude.

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