Increased awareness of intimate partner abuse after training: a randomised controlled trial.
BACKGROUND
Intimate partner abuse is very common among female patients in family practice. In general, doctors overlook the possibility of partner abuse.


OBJECTIVE
To investigate whether awareness of intimate partner abuse, as well as active questioning, increase after attending focus group and training, or focus group only.


METHODS
Randomised controlled trial in a stratified sample.


METHODS
Family practices in Rotterdam and surrounding areas.


METHODS
A full-training group (n = 23), a group attending focus group discussions alone (n = 14), and a control group (n = 17) were formed. Data were collected with incident reporting of every female patient (aged >18 years) that was suspected of, or presented, partner abuse during a period of 6 months. The primary outcome measure was the number of reported patients; the secondary outcome measure was the number of patients with whom the GP had non-obvious reasons to suspect/discuss abuse.


RESULTS
Comparison of the full-training group (n = 87 patients) versus the control group (n = 14 patients) resulted in a rate ratio of 4.54 (95% confidence interval [CI] = 2.55 to 8.09, P <0.001); the focus group only group (n = 30 cases) versus control group: rate ratio of 2.2 (95% CI = 1.14 to 4.26, P = 0.019); full-training versus the focus group only group: rate ratio of 2.19 (95% CI = 1.36 to 3.52, P = 0.001). Comparison of the fulltraining group with the untrained groups for awareness of partner abuse in case of non-obvious signs resulted in: odds ratio 5.92 (95% CI = 2.25 to 15.62, P <0.01) all corrected for sex, district, practice setting, working part/full-time, experience, and age of the doctor.


CONCLUSIONS
Training was the most significant determinant to improve awareness and identification of intimate partner abuse. Active questioning increased, especially where there were non-obvious signs. The focus group on its own doubled the awareness of partner abuse.
Lo Fo Wong
Sylvie
S
Raboud University Medical Centre, Department of Family Medicine/Women's Studies Medical Sciences, Nijmegen, The Netherlands. s.lofowong@hag.umcn.nl
Wester
Fred
F
Mol
Saskia S L
SS
Lagro-Janssen
Toine L M
TL
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010817:Physician-Patient Relations; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000175:diagnosis* / Q000706:statistics & numerical data