A Cochrane Systematic Review released today demonstrates that there is insufficient evidence to justify widespread screening in healthcare settings of women for intimate partner violence (IPV).
Lead author Dr Angela Taft, from the Mother and Child Health Research Centre at La Trobe University, said that there has been an assumption in healthcare circles that screening women for IPV is an essential step in protecting women from this type of violence and that clinicians will actually do it.
However, there is growing evidence that screening does not work, and that many clinicians are unprepared and unwilling to undertake screening anyway.
‘Currently, women with symptoms are asked about IPV, but some organisations recommend asking all women,’ said Dr Taft. ‘However, the question posed by the Cochrane Review was, what evidence is there to suggest that screening will increase identification of IPV and actually improve the wellbeing of the women involved?’
Cochrane Reviews, published by the Cochrane Collaboration, are systematic reviews of primary research in human healthcare and health policy, and aim to assess, in the most rigorous way, the effectiveness of a range of health interventions for prevention, treatment and rehabilitation.
‘The Cochrane Review that we conducted thus aimed to assess the effectiveness of screening women for IPV, by analysing 11 trials that had been conducted over the last 11 years,’ said Dr Taft.
‘There is evidence that when clinicians do screen for IPV, they identify more women who are experiencing IPV. However, the evidence shows that the numbers of women ready to take up referrals are very small,’ said Dr Taft.
‘Nurses and doctors are not screening in sufficient numbers even when taking part in a research study, and are not well equipped to support women when they do identify them through screening.
‘There is insufficient evidence on which to judge whether screening increases take-up of specialist support services.’
Dr Taft acknowledged the recent concern raised by the Victorian Police Commissioner in The Age on 22 April about the levels of family violence and said that health care providers do have a critical role to play.
‘However, a key issue in the current screening process is whether or not healthcare professionals are adequately trained to screen women, so that they know what sort of questions to ask. Most importantly, healthcare professionals need to feel confident that they know what to do when women disclose, and how to help both women who are ready to take action, and those who are not, to improve their safety and that of their children.’
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