Interpersonal violence screening for ambulatory gynecology patients

Abstract

Objective: To estimate the effects of patient and health care provider variables on rates of interpersonal violence screening in an ambulatory gynecology practice.

Methods: A cross-sectional study of 300 patients were chosen randomly from annual health care visits during 2007 at a university-affiliated ambulatory gynecology clinic. All encounters were recorded on a standardized health history form, which included questions about abuse history. Data on patient and health care provider characteristics were collected. The association of health care provider screening with selected patient variables was assessed using multivariable logistic regression.

Results: The median age of the study population was 29 years (range 15-73 years). The cohort was racially and ethnically diverse, and the majority was on government assistance. Sixty-seven percent (194 of 291) had children living at home, and 57% (164 of 286) were single. Of the 300 patients, 243 (81%) had documentation of abuse screening in their medical records. Variables previously found to be associated with higher rates of partner abuse such as younger age or increased parity did not influence whether patients were screened. Similarly, differences in screening by health care provider type (nurse practitioner or resident) or health care provider gender did not emerge. Patients were, however, significantly more likely to be questioned about partner violence when they received other preventive screening (adjusted odds ratio 2.50, 95% confidence interval 1.26-4.99) or presented with a somatic pain complaint (adjusted odds ratio 2.55, 95% confidence interval 1.12-5.83).

Conclusion: Ambulatory gynecology patients were more likely to be screened for interpersonal violence when health care providers performed other preventive health screening using a standardized health history form.

Level of evidence: II.