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Primary care assessment of intimate partner violence and referrals may prevent its recurrence

When female primary care patients, who had been victims of intimate partner violence (IPV), were given a wallet-sized referral card from a local women's center that listed a safety plan and sources for IPV services (shelter, legal, counseling, and police) or a 20-minute counseling session with a nurse case manager, they tended to suffer less abuse in the next year or two. They also tended to adopt more safety behaviors, such as hiding a bag or money for an escape or alerting neighbors to call the police if they heard any violence, according to a study supported by the Agency for Healthcare Research and Quality (HS11079).

Thus, abuse assessment and referral seems sufficient to reduce reported levels of violence. Once abuse is disclosed and acknowledged, the woman's experience is validated and help-seeking is legitimized, explains Janet Y. Groff, M.D., Ph.D., of the University of Arizona, College of Medicine, in Tucscon, and Judith McFarlane, R.N., Dr.P.H. of Texas Women's University in Houston. Drs. Groff and McFarlane and colleagues randomized 360 abused women visiting urban primary care clinics, who had suffered IPV in the past 12 months, to either a wallet-sized referral card or a 20-minute nurse case management protocol. Both groups were contacted every 6 months to make an appointment with the clinic for a 1-hour interview.

Two years following treatment, both treatment groups of women reported a mean of 14.5 fewer threats of abuse, 15.5 fewer assaults, 2.6 fewer risks of homicide, and 2.7 fewer incidents of work harassment. Also, within 2 years, both groups of women adopted a mean of two more safety behaviors. The use of community resources decreased for both groups. The routine contact every 6 months with a nurse may have provided the women with ample support so that many of them did not need access to another resource. However, more research is needed about the perceived benefits of nurse case management for abused women.

More details are in "Secondary prevention of intimate partner violence," by Dr. McFarlane, Dr. Groff, Jennifer A. O'Brien, M.A., and Kathy Watson, M.S., in the January 2006 Nursing Research 55(1), pp. 52-61.

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