Reproductive violence screening in primary care: perspectives and experiences of patients and battered women.
OBJECTIVE: To ascertain how women want health care providers to address domestic violence during primary care visits. METHODS: 80 female patients seen at an urban family practice and 91 women from four urban domestic violence programs (64 outreach clients and 27 shelter residents) were asked about screening for domestic violence between February and May 1996. Domestic violence was defined as physical and/or sexual violence by a male intimate partner. RESULTS: 7.7% of the 40 nonabused women patients reported being previously asked about abuse compared with 25.0% of the 40 abused women patients, 44.4% of outreach clients, and 37.0% of shelter residents. No patients had used community domestic violence services. Most women agreed that health care providers should screen female patients for abuse. Nonabused women typically suggested general screening questions, compared with the more specific screening questions suggested by abused women. Suggested provider interventions reflected recommendations by medical organizations. Fear of losing control and personal feelings (e.g., shame) inhibited some women from discussing abuse with physicians. CONCLUSIONS: Both nonabused and abused women agreed that health care providers should screen female patients for domestic violence. Integrating medical recommendations with practices acceptable to patients is an important step in developing feasible protocols that can be maintained in routine practice.