The impact of perceived barriers on primary care physicians' screening practices for female partner abuse.
OBJECTIVE
Our purpose was to examine primary care physicians' screening practices for female partner abuse in different clinical situations and to investigate the relationship between perceived barriers and screening practices.


METHODS
A cross-sectional survey was mailed to Alaska physicians practicing in the following specialties: family practice, internal medicine, obstetrics/gynecology and general practice.


RESULTS
The survey response rate was 80 percent (305/383). The majority (85.7%) of primary care physicians screened often or always when a female patient presents with an injury, but they rarely screened at initial visits (6.2%) or annual exams (7.5%). More than one-third of respondents estimated that 10% or more of their female patients had experienced some type of intimate partner abuse. Several barriers to screening described in the literature were not predictive of physicians' screening practice patterns. Physicians' perceptions that abuse is prevalent among their patients and physicians' beliefs that they have a responsibility to deal with abuse were the only variables independently associated with screening at initial visits and annual exams. The only variable predictive of screening when a patient presents with an injury was physicians' perceived prevalence of abuse.


CONCLUSIONS
Primary care physicians have not integrated screening for partner abuse into routine care. Strategies to increase awareness of the high prevalence of abuse in the primary care setting and to educate providers on the negative health effects of victimization can help physicians to acknowledge their responsibility in addressing abuse and the importance of screening at routine visits. Further rigorous studies are needed to identify and evaluate predictors of screening for abuse.
Alaska Family Violence Prevention Project, Section of Maternal, Child and Family Health, Department of Health and Social Services, Anchorage 99524-0249, USA. Linda_Chamerlain@health.state.ak.us
Linda
L
Chamberlain
Katherine A
KA
Perham-Hester
D000328:Adult; D000413:Alaska; D001291:Attitude of Health Personnel; D018585:Battered Women; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006176:Gynecology / Q000592:standards; D019538:Health Care Surveys; D006801:Humans; D007388:Internal Medicine / Q000592:standards; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008487:Medical History Taking; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011320:Primary Health Care / Q000592:standards*; D012747:Sexual Partners / Q000523:psychology*; D013179:Spouse Abuse / Q000175:diagnosis* / Q000517:prevention & control / Q000706:statistics & numerical data