Domestic violence: a comparative survey of levels of detection, knowledge,and attitudes in healthcare workers

The objective of this study was to compare the knowledge, attitudes, respon ses and levels of detection of domestic violence among a variety of healthc are workers in different specialities. Self-administered questionnaires were sent to community and hospital based healthcare workers in Oxfordshire working in primary care, obstetrics and g ynaecology, mental health and accident and emergency. These comprised all p rincipal general practitioners and general practitioner registrars, 50% of practice/district nurses and health visitors in each practice, and all heal thcare workers in obstetrics and gynaecology, community mental health teams and accident and emergency in one trust. The amount of domestic violence detected in different healthcare settings w as far less than indicated by anonymous surveys and crime figures. Knowledg e about many of the issues surrounding domestic violence was inconsistent a nd there were fundamental deficiencies. The attitudes of healthcare workers to domestic violence were generally sympathetic and supportive. Women, nur ses and community mental health workers reported significantly better knowl edge and more positive attitudes than other respondents. Gender, role and s peciality were independently associated with more positive attitudes and th e latter two were independently associated with good knowledge. The respons e that healthcare workers make when they uncover domestic violence is confu sed and often inappropriate. In conclusion, most healthcare workers accept that domestic violence is a h ealthcare issue but lack fundamental knowledge about the issues surrounding domestic violence itself and appropriate agencies that can offer help. The y also lack skills in identifying and discussing this issue with patients/c lients. A large, unfulfilled training need has been identified.