Women & health
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Even though current domestic violence guidelines, such as those published by the AMA in 1992, attempt to relieve physicians of the "full burden of intervention," they continue to call upon physicians to play a large role in identifying, intervening in, and following up on case of partner abuse. In this paper, we define a limited domestic violence role for physicians which furthers the direction recommended by the AMA and which complements exemplary programs. We propose simplifying and limiting physicians' tasks to Asking patients about abuse; providing Validating messages, acknowledging that battering is wrong and confirming patient worth; Documenting presenting signs, symptoms, and disclosures; and Referring victims to domestic violence specialists (AVDR). By drawing on the literature and our own experience, we show how focusing the physician's role on these four taks is consistent with exemplary programs and expands on ideas put forth by experts for addressing domestic violence in health care settings; reduces barriers for physician interventions with victims; offers a realistic approach for physicians, reducing unrealistic educational demands; and complements managed care trends in contemporary health care.
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Comparative Study
Domestic violence in later life: an overview for health care providers.
Domestic violence is a significant problem that adversely affects the health and safety of millions of women throughout their life-span. Most cases of what is considered elder abuse occurs at home rather than in institutions, and the evidence suggests that only 1 in 5 cases are recognized. ⋯ Improving the ability of physicians to identify domestic violence is an important skill needed for establishing comprehensive intervention and prevention efforts. In addition to conducting universal screening of all female patients, using clinical and behavioral indicators is a critical component of the intervention.
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The incidence of acute cases of intimate partner violence (IPV) in the Emergency Department (ED) patients is between 2 and 7.2%. Ongoing IPV may be an immediate cause of presentation for medical care, or it may not be readily apparent. Over the last two decades efforts to improve identification of IPV in the ED have been successful. ⋯ Detection of IPV in patients presenting to the ED can be improved by providing educational programs and screening tools to health care providers. Sustaining the screening programs is more difficult and requires a health care system-wide effort.
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This study examines the associations among relationship power, sexual decision-making dominance, and condom use within a sample of women at risk of HIV/STDs. Data from face-to-face interviews with 112 women were analyzed to (a) describe who women perceive as more powerful and who makes sexual decisions within their heterosexual relationships, (b) explore the association between relationship power and sexual decision-making dominance, and (c) examine the relationship of power and decision making regarding condom use to condom use behavior. Women were recruited from clinics and community locations in Atlanta, Los Angeles, Oklahoma City and Portland, OR. ⋯ A higher percentage of women who perceived that they have more power or share power, as compared to those who perceived that their partners have more power, reported that "I/We" make decisions about birth control use, condom use, whether to have sex, and type of sexual activity. Relationship power was not associated with condom use. Condom use was, however, significantly higher among women who reported that they make decisions about using condoms alone or with their partner as compared to those who reported that their partner makes those decisions.