Improving the response of general practice to adult patients experiencing and perpetrating domestic violence and to their children

2021 ◽  
Author(s):  
Eszter Szilassy ◽  
Melissa Cole
Keyword(s):  
Domestic Violence ◽  
General Practice ◽  
Adult Patients

scholarly journals Exposure to domestic violence and abuse and consultations for emergency contraception: nested case-control study in a UK primary care dataset

2018 ◽  
Vol 69 (680) ◽  
pp. e199-e207 ◽  
Author(s):  
Joni Jackson ◽  
Natalia V Lewis ◽  
Gene S Feder ◽  
Penny Whiting ◽  
Timothy Jones ◽  
...  
Keyword(s):  
Primary Care ◽  
Domestic Violence ◽  
General Practice ◽  
Emergency Contraception ◽  
Case Control Study ◽  
Case Control ◽  
Exposure To Domestic Violence ◽  
Nested Case Control ◽  
Domestic Violence And Abuse ◽  
Control Study

BackgroundEvidence of an association between exposure to domestic violence and abuse (DVA) and use of emergency contraception (EC) is lacking in the UK.AimTo quantify the association between exposure to DVA and consultations for EC in general practice.Design and settingNested case-control study in UK general practice.MethodUsing the Clinical Practice Research Datalink, the authors identified all women all women aged 15–49 years registered with a GP between 1 January 2011 and 31 December 2016. Cases with consultations for EC (n = 43 570) were each matched on age and GP against four controls with no consultations for EC (n = 174 280). The authors calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between exposure to DVA in the previous year and consultations for EC. Covariates included age, ethnicity, socioeconomic status, pregnancy, children, alcohol misuse, and depression.ResultsWomen exposed to DVA were 2.06 times more likely to have a consultation for EC than unexposed women (95% CI = 1.64 to 2.61). Women aged 25–39 years with exposure to DVA were 2.8 times more likely to have a consultation for EC, compared with unexposed women (95% CI = 2.08 to 3.75). The authors found some evidence of an independent effect of exposure to DVA on the number of consultations for EC (OR 1.48, 95% CI = 0.99 to 2.21).ConclusionA request for EC in general practice can indicate possible exposure to DVA. Primary care consultation for EC is a relevant context for identifying and responding to DVA as recommended by the World Health Organization and National Institute for Health and Care Excellence guidelines. DVA training for providers of EC should include this new evidence.

scholarly journals Prospectively Collected Characteristics of Adult Patients, Their Consultations and Outcomes as They Report Breathlessness When Presenting to General Practice in Australia

PLoS ONE ◽  
2013 ◽  
Vol 8 (9) ◽  
pp. e74814 ◽  
Author(s):  
David C. Currow ◽  
Katherine Clark ◽  
Geoffrey K. Mitchell ◽  
Miriam J. Johnson ◽  
Amy P. Abernethy
Keyword(s):  
General Practice ◽  
Adult Patients

scholarly journals Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Natalia V. Lewis ◽  
Cath Larkins ◽  
Nicky Stanley ◽  
Eszter Szilassy ◽  
William Turner ◽  
...  
Keyword(s):  
Domestic Violence ◽  
General Practice ◽  
Mixed Method ◽  
Method Evaluation ◽  
Pilot Intervention

scholarly journals Responding to Domestic Violence in General Practice: A Qualitative Study on Perceptions and Experiences

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Howa Yeung ◽  
Nubaha Chowdhury ◽  
Alice Malpass ◽  
Gene S. Feder
Keyword(s):  
Domestic Violence ◽  
General Practice ◽  
Social History ◽  
Time Constraints ◽  
Community Resources ◽  
Support Programme ◽  
Patient Interaction ◽  
Effective Interventions ◽  
Training Programmes ◽  
Training And Support

The perceptions and experiences among general practitioners (GPs) and nurses in identifying female patients experiencing domestic violence and referring patients to specialist agencies need to be clarified. Eleven GPs and six nurses participating in a multidisciplinary domestic violence training and support programme in east London and Bristol were interviewed. All participants recognised that identification of women experiencing domestic violence and offering support were part of their clinical roles. Perceived differences between GPs and nurses, including time constraints, level of patient interaction, awareness of patients' social history, scope of clinical interview, and patient expectations were used to explain their levels of domestic violence inquiry. Barriers to inquiry included lack of time, experience, awareness of community resources, and availability of effective interventions postdisclosure. Longstanding relationships with patients were cited both as barrier and facilitator to domestic violence disclosure. Some nurses reported discomfort with direct inquiry due to the lack of clinical experience in responding to domestic violence despite satisfaction with training. Future domestic violence training programmes should take into account potential differences between GPs and nurses, in terms of their clinical roles and the unique barriers encountered, in order to improve self-efficacy and to facilitate collaborative and effective responses.

scholarly journals Prevalence of intimate partner violence disclosed during routine screening in a large general practice

2015 ◽  
Vol 7 (2) ◽  
pp. 102 ◽  
Author(s):  
Debs Higgins ◽  
Kathy Manhire ◽  
Bob Marshall
Keyword(s):  
Domestic Violence ◽  
General Practice ◽  
Intimate Partner Violence ◽  
New Zealand ◽  
Partner Violence ◽  
Health Centre ◽  
Intimate Partner ◽  
Routine Screening ◽  
Positive Rate ◽  
Disclosure Rate

INTRODUCTION: Domestic violence in its myriad shapes and forms is a crime affecting every level of society. Gaining a true understanding of intimate partner violence (IPV) victimology allows for the meaningful provision of intervention services. AIM: To explore the prevalence of IPV disclosure during routine screening in a large general practice in provincial New Zealand. METHODS: Data were collected from 13 October 2008 to 30 June 2014 from 6827 individuals screened for IPV on 10 062 occasions and were analysed relative to age, ethnicity, gender, screening outcome, screener and health centre enrolled status. RESULTS: Analysis indicated an overall ever-positive disclosure rate of IPV of 11.1%, lower than New Zealand studies that place ever-positive prevalence as high as 78%. Maori women disclosed an ever-positive rate of 21.6%, Pacific women 13.2%, compared to 8.9% for NZ European/Other women. Casual patients positively disclosed in 13.7% of instances as opposed to enrolled patients in 10.5%. Disclosure of past abuse was made 1.3 times more often than that of a current abusive situation. Those aged between 16 and 65 years disclosed an ever-positive rate =10%. While nurses screened 5.5 times more patients than doctors, the doctors facilitated a higher percentage of positive disclosures than the nurses. DISCUSSION: Disclosure rates from a general practice setting do not mirror those of population studies or administrative datasets due to differences in samples and data collection methods. Routine annual screening is effective, with both doctors and nurses providing support for approximately equal numbers of patients in immediate danger. KEYWORDS: Disclosure; domestic violence; ethnic groups; general practice; women

scholarly journals Recommendations for the treatment of epilepsy in adult patients in general practice in Belgium: an update

2012 ◽  
Vol 112 (2) ◽  
pp. 119-131 ◽  
Author(s):  
Paul Boon ◽  
Sebastiaan Engelborghs ◽  
Henri Hauman ◽  
An Jansen ◽  
Lieven Lagae ◽  
...  
Keyword(s):  
General Practice ◽  
Adult Patients ◽  
Treatment Of Epilepsy

scholarly journals Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eszter Szilassy ◽  
Jessica Roy ◽  
Emma Williamson ◽  
Katherine Pitt ◽  
Mei-See Man ◽  
...  
Keyword(s):  
Primary Care ◽  
Domestic Violence ◽  
General Practice ◽  
Service Providers ◽  
System Level ◽  
Sources Of Information ◽  
Care Needs ◽  
Post Intervention ◽  
Support Intervention ◽  
Training And Support

Abstract Background Primary care needs to respond effectively to patients experiencing or perpetrating domestic violence and abuse (DVA) and their children, but there is uncertainty about the value of integrated programmes. The aim of the study was to develop and test the feasibility of an integrated primary care system-level training and support intervention, called IRIS+ (Enhanced Identification and Referral to Improve Safety), for all patients affected by DVA. IRIS+ was an adaptation of the original IRIS (Identification and Referral to Improve Safety) model designed to reach female survivors of DVA. Methods Observation of training; pre/post intervention questionnaires with clinicians and patients; data extracted from medical records and DVA agency; semi-structured interviews with clinicians, service providers and referred adults and children. Data collection took place between May 2017 and April 2018. Mixed method analysis was undertaken to triangulate data from various sources to assess the feasibility and acceptability of the intervention. Results Clinicians and service providers believed that the IRIS+ intervention had filled a service gap and was a valuable resource in identifying and referring women, men and children affected by DVA. Despite increased levels of preparedness reported by clinicians after training in managing the complexity of DVA in their practice, the intervention proved to be insufficient to catalyse identification and specialist referral of men and direct identification and referral (without their non-abusive parents) of children and young people. The study also revealed that reports provided to general practice by other agencies are important sources of information about adult and children patients affected by DVA. However, in the absence of guidance about how to use this information in patient care, there are uncertainties and variation in practice. Conclusions The study demonstrates that the IRIS+ intervention is not feasible in the form and timeframe we evaluated. Further adaptation is required to achieve identification and referral of men and children in primary care: an enhanced focus on engagement with men, direct engagement with children, and improved guidance and training on responding to reports of DVA received from other agencies.

scholarly journals Is it coercive controlling violence? A cross-sectional domestic violence and abuse survey of men attending general practice in England.

2017 ◽  
Vol 7 (3) ◽  
pp. 417-427 ◽  
Author(s):  
Marianne Hester ◽  
Cassandra Jones ◽  
Emma Williamson ◽  
Eldin Fahmy ◽  
Gene Feder
Keyword(s):  
Domestic Violence ◽  
General Practice ◽  
Cross Sectional ◽  
Domestic Violence And Abuse
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