How to screen for domestic violence against women in primary health care centers

BackgroundViolence against women is a major public health problem. Primary health care workers are involved in both detection and management of violence. Screening of women for violence is an important tool for early detection and prevention of violence through a valid and accepted screening tool.ObjectivesThe purpose of this study was to identify the main elements and characteristics of a violence screening tool that can be used in primary health care centers.MethodsAn observational cross-sectional study was carried out in primary health care centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A self-administrative questionnaire was used for data collection.ResultsPhysicians favored an indirect question about violence (79.7%), while a question about feeling safe (83.6%) was suggested by nurses. The most frequently suggested method was searching for signs of violence. The majority of both nurses (82.4%) and physicians (82.0%) suggested physicians to carry out the screening process for domestic violence against women. The primary health care level was suggested to be in charge of screening for violence by 88.7% of nurses and 82.0% of physicians. Both nurses and physicians agreed that the examination should be carried out in complete privacy (95.0% and 91.4%), by an examiner of the same sex (89.1% and 89.8%), and not allowing a relative of the victim to attend the screening (85.3% and 78.9%). Opportunistic screening was preferred by both physicians (69.5%) and nurses (87.8%) when manifestations of violence are noticed.ConclusionA short tool containing a question about safety and looking for signs of violence administered by a physician on opportunistic basis in the primary health care centers in complete privacy was suggested for screening of women.