Domestic violence and abuse, health status, and social functioning.
BACKGROUND
Current and past history of domestic violence (DV), including physical, sexual, and emotional abuse is common among women patients seen in health care settings and is associated with a higher frequency of many health problems. However, the association of DV with self-assessed social functioning is less well known.


METHODS
We administered a telephone survey to a random sample of 391 women HMO members seen for a routine annual check-up. The survey included questions about current and past physical, sexual, and emotional violence and self-assessed social functioning and health status from the SF-36. We included questions about attitudes toward routine DV screening, likelihood of disclosure, and the health care setting as a resource.


RESULTS
Seven percent of the women reported recent DV and 34% reported lifetime abuse. Abuse was related to limitations in social functioning (adjusted OR = 2.26). Among women with no recent history of abuse, those with a history of past physical (adjusted OR = 1.90), sexual (adjusted OR = 2.04), or emotional (adjusted OR = 2.20) abuse reported significantly poorer social functioning. Emotional abuse, even in the absence of a history of physical or sexual abuse, was strongly associated with limitations in social functioning (adjusted OR = 4.95). Most women believed it appropriate for clinicians to inquire routinely about DV (87%) and 83% believed that the health care setting was a source of help.


CONCLUSIONS
Current and past DV, including emotional abuse, adversely affect social functioning. Therefore, clinicians in the health care setting have a unique and important opportunity to assist women victims of DV and abuse.
McCaw
Brigid
B
Family Violence Prevention Program, Kaiser Permanente Northern California, Oakland, CA 94612, USA. Brigid.McCaw@kp.org
Golding
Jacqueline M
JM
Farley
Melissa
M
Minkoff
Jerome R
JR
D000328:Adult; D001294:Attitude to Health; D018585:Battered Women / Q000523:psychology / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016387:Women's Health