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Discussion On Domestic Violence Increased By Computer Based Screening

determine if domestic violence was discussed, disclosed or treated during each encounter.

Of the 903 women who completed the exit questionnaire, 26 percent at the urban ED and 21 percent at the suburban ED indicated they were at risk for domestic violence. A total of 871 women (331 from the suburban location and 540 from the urban site) were successfully audiotaped; among women who were audiotaped and disclosed domestic violence on the exit questionnaire, those who completed the computer screening were more likely to talk to a physician or nurse practitioner about domestic violence and twice as likely to disclose domestic violence during the ED visit than those who received standard care. In the urban ED, women who completed the computer survey were more likely than those who received routine care to discuss domestic violence with their clinician (56 percent vs. 45 percent), disclose their own domestic violence situations (14 percent vs. 8 percent) or receive care or referrals for domestic violence (8 percent vs. 4 percent, or 57 percent vs. 43 percent of the women who disclosed domestic violence). Women at the suburban site were much less likely to discuss (11 percent in the computer screening group and 9 percent in the standard group) or disclose domestic violence (5 percent in both groups).

At both sites, only 48 percent of the women (17 percent in the suburban ED and 61 percent in the urban ED) whose computer surveys generated a domestic violence prompt for the physician had a discussion about domestic violence during their visit. ‘Domestic violence is a highly prevalent condition, but detection in the ED remains elusive,’ the authors conclude. ‘We found that female patients will disclose their domestic violence risk to a computer. Our study both supports the potential for computer screening to increase identification and referral for domestic violence and raises the concern that ED physicians, particularly suburban physicians, may need additi
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