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Background: This two-part study examines primary care clinicians' chart documentation and attitudes when confronted by a positive waiting room screen for intimate partner violence (IPV). Methods: Patients at community hospital-affiliated health centers completed a screening questionnaire in waiting rooms that primary care providers (PCPs) were subsequently given at the time of the visit. We first reviewed the medical records of patients who screened positive for IPV, evaluating the presence and quality of documentation. Next we administered a survey to PCPs that measured their knowledge, attitudes and practice regarding IPV. Results: Seventy-two percent of charts contained some documentation of IPV, however only 10% contained both a referral and safety plan. PCPs were more likely to refer patients (p < .05) who screened positively for mood or anxiety disorders, disclosed that they feared for their safety or were economically disadvantaged. Those that feared for their safety or endorsed mood or anxiety disorders were more likely to have notation of a safety plan in their records. When surveyed, 81.6 of clinicians strongly agreed that it is their role to inquire about IPV, but only 68% expressed confidence in their ability to manage it. In contrast, 93% expressed confidence in managing depression. Sixty-seven percent identified time constraints as a barrier to care. Predictors of PCP confidence in treating patients who have experienced IPV (p < .05) included hours of recent training and clinical experience with IPV. Conclusion: Mandatory waiting room screening for IPV does not result in high levels of referral or safety planning by PCPs. Despite the implementation of a screening process, clinicians lack confidence and time to address IPV in their patient populations suggesting that alternative methods of training and supporting PCPs need to be developed. [ABSTRACT FROM AUTHOR]

Objective: to quantify head and neck injuries in known adult victims of intimate-partner violence (IPV)., Design: retrospective chart review., Setting: sexual assault and domestic violence program in a southeastern Ontario hospital., Methods: all subjects over the age of 16 years consenting for evaluation by a domestic violence nurse from August 2004 until February 2009 were eligible for inclusion. Subjects for which no physical injury was documented were excluded. Data were extracted from body maps and surveys completed by a specially trained domestic violence nurse. Demographic data, mechanisms of injury, relationship to the assailant, and a history of IPV from the same assailant were collected from the survey. The type and anatomic location of the injury were collected from body maps. Injuries were categorized into six larger categories for analysis according to general anatomic area and multiplicity of areas involved., Main Outcome Measure: anatomic location of the injury., Results: one hundred eight visits were eligible for inclusion in the study. Data on 657 injuries were recorded. The frequency of any head and neck injury was significantly greater than no head and neck injury (p < .001). In subjects experiencing multiple areas of injury, head and neck injuries were significantly more common than not (p < .001). In subjects experiencing only one area of injury, head and neck injuries were more common than lower extremity injuries alone (p = .003) and trunk injuries alone (p = .033) but not significantly more common than upper extremity injuries (p = .102)., Conclusions: head and neck injuries are more common than not in known adult victims of IPV.

Background: Intimate partner violence (IPV) is a widespread public health problem and training of health professions students has become common. Understanding students' prior knowledge, attitudes and personal exposure to IPV will aid educators in designing more effective curriculum. As interprofessional educational efforts proliferate, understanding differences across disciplines will be critical., Findings: Students in the schools of Medicine, Nursing and Rehabilitation at a university in Ontario attend an annual daylong interprofessional IPV training. To measure perceived role and comfort with IPV and prior personal exposure, we administered a brief Likert scale survey to a convenience sample of students over three years. 552 students completed the survey; the overall response rate was 73%. The majority (82%) agreed that it was their role to intervene in cases of IPV; however Rehabilitation students expressed lower overall comfort levels than did their peers in other schools (p < .0001). Gender, age and prior training on the subject were not significant predictors of comfort. Seven percent reported lifetime IPV and one-fifth had witnessed IPV, but these exposures did not predict comfort in adjusted logistic regression models., Conclusion: While the majority of professional students believe it is their role to address IPV in clinical practice, comfort level varied significantly by field of study. More than one fifth of the students reported some personal exposure to IPV. However this did not impact their level of comfort in addressing this issue. Educators need to take students' preexisting attitudes and personal exposure into account when planning curriculum initiatives in this area.