The factors associated with disclosure of intimate partner abuse to clinicians.
OBJECTIVE
Our goal was to identify the prevalence, determinants of, and barriers to clinician-patient communication about intimate partner abuse.


METHODS
We conducted telephone interviews with a random sample of ethnically diverse abused women.


METHODS
We included a total of 375 African American, Latina, and non-Latina white women aged 18 to 46 years with histories of intimate partner abuse who attended 1 of 3 primary care clinics in San Francisco, California, in 1997.


METHODS
We measured the relevance and determinants of past communication with clinicians about abuse and barriers to communication.


RESULTS
Forty-two percent (159) of the patients reported having communicated with a clinician about abuse. Significant independent predictors of communication were direct clinician questioning about abuse (odds ratio [OR]=4.6; 95% confidence interval [CI] 3.2-6.6), and African American ethnicity (OR=1.8; 95% CI, 1.1-2.9). Factors associated with lack of communication about abuse included immigrant status (OR=0.6; 95% CI, 0.3-1.0) and patient concerns about confidentiality (OR=0.7; 95% CI, 0.5-0.9). Barriers significantly associated with lack of communication were patients' perceptions that clinicians did not ask directly about abuse, beliefs that clinicians lack time and interest in discussing abuse, fears about involving police and courts, and concerns about confidentiality.


CONCLUSIONS
Clinician inquiry appears to be one of the strongest determinants of communication with patients about partner abuse. Other factors that need to be addressed include patient perceptions regarding clinicians' time and interest in discussing abuse, fear of police or court involvement, and patient concerns about confidentiality.
Rodríguez
M A
MA
Department of Family and Community Medicine, University of California, San Francisco, CA 94110, USA. MRodriguez@MedSch.ucsf.edu
Sheldon
W R
WR
Bauer
H M
HM
Pérez-Stable
E J
EJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D003142:Communication; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D013179:Spouse Abuse / Q000706:statistics & numerical data; D014342:Truth Disclosure; D044465:White People