Researchers at Johns Hopkins School of Nursing and other institutions report that nearly 4 in 10 female emergency room patients have been victims of physical or emotional domestic abuse sometime in their lives, and 14 percent have been physically or sexually abused in the past year.
Results of their survey of 3,455 women age 18 and over who came for treatment to 11 community hospital emergency departments in California and Pennsylvania will be published in the August 5 issue of the Journal of the American Medical Association.
The women in the study were seen in the emergency department for care of various ailments not necessarily related to abuse. Thirty-eight percent of the population indicated they have been either emotionally or physically abused by an intimate partner during their lifetime, and one in every seven women reported being a victim of physical or sexual abuse in the past year.
"The prevalence of domestic violence is higher than most people think. We now estimate that between 700,000 and 1,100,000 women every year seek care at emergency departments for acute injuries incurred from abuse," says Jacquelyn Campbell, PhD, RN, professor at the Johns Hopkins University School of Nursing and principal investigator of the study. "That estimate does not include the significant numbers of additional women who seek care at emergency departments for indirect symptoms of abuse, such as emotional stress or chronic pain from previous injuries."
Significantly higher rates of abuse were found among women between the ages of 18 and 39 and women in low-income households. Campbell says the study also revealed that separation from a partner is an important risk factor for abuse. Women in the survey who have ended a relationship in the past year were seven times more likely to experience abuse from the estranged partner.
"This study suggests that we, as health care professionals, need to identify abuse before the patient receives a much more dangerous or even fatal injury," says Campbell. "Evidence from the study shows that all emergency departments need to develop a protocol for screening female patients between the ages of 16 and 60 for domestic violence and if necessary, making the appropriate referrals."
The study was funded by the Centers for Disease Control. Other authors include Stephen Dearwater, Jeffrey Coben and Gregory Nah (Allegheny University of the Health Sciences, Pittsburgh, PA), Nancy Glass (Johns Hopkins), Elizabeth McLoughlin (San Francisco Injury Center for Research and Prevention, San Francisco, CA), and Betty Bekemeier (Tacoma-Pierce County Health Department, Tacoma, WA).
Campbell's work has led the Johns Hopkins Hospital to institute a domestic violence screening protocol for its female emergency department patients.
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JAMA