Intimate Partner Violence Education for Health Care Providers

Abstract

Purpose: The purpose of this systematic literature review is to (1) present research on current IPV screening prevalence within the medical community, (2) emphasize the importance of IPV screening for physical therapists,(3) identify barriers that exist to IPV screening, (4) examine current teaching methods for IPV within healthcare curriculums and (5) identify valid and reliable IPV screening tools for clinical application.

Description: A comprehensive systematic literature search on six different databases was completed from September 2012 to March 2013. Search terms included intimate partner violence (IPV), domestic violence, health providers and IPV screening tools. Randomized control trials were included if they evaluated at least one IPV screening tool utilized in the study. Three independent reviewers screened 5664 results and identified 55 relevant research studies. These studies were evaluated utilizing a modified PEDro scale.

Summary of Use: Methodological quality ranged from 6 to 13/14. Five studies were excluded due to poor quality research data or design. Despite the established importance of IPV screening by healthcare professionals, the research has demonstrated that healthcare professionals are not providing universal screening for all patients. Only 8% of physical therapists routinely screen for IPV. Challenges exist in the healthcare field in the screening of patients for IPV: including (1) differing cultural perspectives on IPV, (2) time constraints, (3) language barriers, (4) lack of knowledge and (5) healthcare practitioners negative perceptions.The most frequent provider-related barriers included “lack of provider education regarding IPV, lack of time, and lack of effective interventions. PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) is a 15 minute survey that Short et al. found to have good internal consistency and reliability (Cronbach’s alpha ≥ 0.65). PREMIS is more current and comprehensive than previous standardized IPV assessment tools and can easily be utilized by physical therapists.

Importance to Members: IPV is a major public health concern with a healthcare cost of nearly $4.1 billion and affects nearly 1/3 of women during their lifetime. Three recommendations can be made for physical therapists based on various models for IPV education. 1) Experiential learning, 2) Utilize APTA’s Blueprint for Teaching Cultural Competence applying it to IPV screening, and 3) Utilization of the PREMIS tool by physical therapists to assess IPV.

The prevalence of IPV and the lack of physical therapist IPV screening, calls for an evaluation of the requirements and screening tools available for physical therapists in the clinic. By improving education for IPV screening, new clinicians can be better prepared for detecting and reporting IPV once they are practicing physical therapists. Research is limited concerning the methods by which physical therapists are instructed in IPV screening.

Keywords: intimate partner violence, women's health, physical therapy, screening