Domestic violence and primary care - Attitudes, practices, and beliefs

Objective: To assess the attitudes and beliefs of the primary care provider team (physicians, physician assistants, nurses, and medical assistants) to ward the identification and management of abused patients and perpetrators of domestic violence (DV). Design: Survey of the health care team using a confidential questionnaire. Setting and Subjects: Five primary care clinics with 240 providers at a lar ge urban health maintenance organization. Results: The response rate was 86% (206 respondents). Fifty percent of clin icians and 70% of nurses/assistants believed that the prevalence of DV in t heir practice was 1% or less; 1 in 10 clinicians and nearly half of nurses/ assistants had never identified an abused person; 45% of clinicians never o r seldom asked about DV when examining injured patients; and all participan ts were much less confident in asking about DV than about smoking or consum ing alcohol. Twentyfive percent believed the abused person's personality le d to the violence; 28% believed they did not have strategies to help abused persons; and 20% were concerned for their personal safety in discussing DV . Only 10% believed they had management information, but 77% had not attend ed any educational programs on DV in the past year. Conclusions: This study provides important information about current knowle dge, attitudes, and beliefs of health care providers toward the diagnosis a nd management of DV. This information should prove useful to all who attemp t to design clinical strategies and educational programs to address this is sue.