Universal screening for intimate partner and sexual violence in trauma patients

Tanya Liv Zakrison · Xiomara D. Ruiz · Rondi Beth Gelbard · David Turay · Xian Luo‐Owen · Nicholas Namias +2 more

27 citations0/0 files storedThe Journal of Trauma: Injury, Infection, and Critical Care

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Intimate Partner and Family Violence Sexual Assault and Victimization Studies Elder Abuse and Neglect

Abstract

BACKGROUND: A single-center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) among both male and female trauma patients, regardless of mechanism of injury. We aimed to determine if this phenomenon was similar to rates in other trauma centers by assessing the feasibility of universal screening and determining the prevalence and association of IPSV with other trauma-associated comorbidities. METHODS: We designed an Eastern Association for the Surgery of Trauma-supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States. Screening occurred from March 2015 to April 2016. We performed universal screening of adult trauma patients using the validated HITS (Hurt, Insult, Threaten, Scream) and SAVE (sexual violence) screening surveys. Trauma recidivism, substance use, and mental illness were also measured and were classified as "trauma-associated comorbidities." Chi-squared test compared categorical variables with significance at p <0.05. Parametric data is presented as mean ± standard deviation. RESULTS: A total of 2,034 eligible trauma patients were screened by clinical social workers at each site over 1 year. The mean age was 37.05 ± 20.32 with 63% men, 37% women, and one transgendered participant. The overall rate of IPSV was 11.4%. The proportion of positive screens for men was 9.3%, with variability between centers (3.8-72.7%), and for women was 16.1% (15.3-50.0%) (p < 0.001). The transgendered patient screened positive for IPSV. Of patients who screened positive for IPSV, 60.0% had one or more trauma-associated comorbidity compared to 15.1% of patients who screened negative (p < 0.001). CONCLUSION: More than one in nine trauma patients is at risk of IPSV, regardless of gender or mechanism of injury. IPSV may be a risk factor for other trauma-associated comorbidities. LEVEL OF EVIDENCE: Prognostic/Epidemiologic, level II; Care Management, level III.

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References

1998Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults 1998HITS: a short domestic violence screening tool for use in a family practice setting.2000Screening for intimate partner violence by health care providersBarriers and interventions 2015Screening women for intimate partner violence in healthcare settings 2009Screening for Intimate Partner Violence in Health Care Settings A Randomized Trial 2011The Helpseeking Experiences of Men Who Sustain Intimate Partner Violence: An Overlooked Population and Implications for Practice 2004Psychological intimate partner violence: the major predictor of posttraumatic stress disorder in abused women 2000Domestic violence and the trauma surgeon

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