"The unexpectedly high rate of IPV in orthopaedics suggests that injury clinics are the ideal location for identification and support programmes for victims of severe abuse who may be at increased risk of further injury and homicide" *, explains Shelia Sprague from McMaster University in Canada who co-led the research with Mohit Bhandari, an orthopaedic surgeon at McMaster University.
"Almost three-quarters of the women in our study believed that health-care providers should ask all women about IPV, and about two-thirds agreed that orthopaedic surgeons are particularly well placed to do this."*
Worldwide, IPV is the leading cause of non-fatal injury to women. Musculoskeletal injuries are the second most common type of injury resulting from IPV and are often seen by orthopaedic surgeons.
The PRAISE study examined the yearly and lifetime prevalence of IPV among 2945 adult women presenting to 12 fracture clinics across Canada, the USA, the Netherlands, Denmark, and India. All the participants anonymously answered direct questioning about abuse and completed two questionnaires (Women Abuse Screening Tool and Partner Violence Screen) in private.
One in six women (16%) disclosed experiencing IPV in the past year, and one in three (34.6%) reported experiencing abuse at some point during their lives.
Also important, say the researchers, is that of the 47 women (2%) who attended their fracture clinic as a direct result of IPV, only 14% said they had ever been asked about abuse by a health-care professional.
According to the PRAISE investigators, "the US Preventive Services Task Force has recently published a statement recommending that all clinicians screen women for IPV… health-care professionals in injury clinics are well positioned to identify patients experiencing IPV, since they often develop long-term interactions with women during repeat clinic visits for follow-up of fractures and associated surgical procedures."
Commenting on the paper, Kelsey Hegarty from the General Practice and Primary Health Care Academic Centre, Carlton, Victoria, Australia says, "Exploration of evidence for strengthening of a system response in a clinical setting to assist women who are experiencing domestic violence, which includes training of staff and clinic champions (staff who take on an extra role promoting domestic-violence-related work in the clinic), establishment of a supportive environment for staff, the creation of several ways for women to access referrals (eg, posters and hospital-specific advocates), and promotion of a team approach, does seem to be justified in fracture clinics in view of the high prevalence of domestic violence."
NOTES TO EDITORS:
*Quotes direct from author and cannot be found in text of Article.
Journal
The Lancet