Screening for intimate partner violence in an urban trauma bay: Use of a self-disclosure survey

Although intimate partner violence (IPV) is a leading cause of serious injury in women, trauma providers consistently fail to capture the true incidence of IPV by screening only those “at risk”. Objective: To determine the incidence of IPV disclosure in the trauma population using a unique, universal Adult Social Health Survey (ASHS). Methods: All trauma patients (>18 yrs old) discharged from a level 1 trauma center were offered the ASHS (2/2008-9/2008). This voluntary, self-administered survey presented questions about IPV in the context of other social health risks and was affixed to a list of community resources. Surveys were reviewed prior to discharge and referrals were made as necessary. Fisher's exact test was used for comparisons. Results: 660 patients were discharged with 131 surveys collected (54 women, 53 men, 24 unknown). 22/131 patients (16.8%) reported a history of physical violence. Women were more likely than men to disclose IPV (24.1% vs 0.06%, p<0.001) with 20.4% of women reporting a history of sexual violence. Women with a history of IPV were more likely than women without IPV to report depression (73.3% vs 33.3%, p=0.009), but did not disclose higher drug or alcohol use. 13% of the women surveyed and only 1.9% of men (p<0.001) reported feeling afraid/threatened by their former or current partner. Conclusions: IPV is a significant problem in the trauma population with over 20% of female patients reporting a history of physical or sexual violence. The ASHS provides an efficient, low-cost means of universal IPV screening in the trauma population.