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Researchers led by Dr. Joanne Klevens, of the U.S. Centers for Disease Control and Prevention, say the findings refute calls for universal screening in primary care settings, which numerous professional and health care organizations now advocate.
The study was published in the Aug. 15 issue of the Journal of the American Medical Association and involved more than 2,700 women receiving care in primary care clinics in 2009 and 2010.
Of these women, 55 percent were black and 37 percent were Latina. The study's authors also noted 57 percent of the women had less than a high school education and 57 percent were uninsured.
The women were divided into three groups: those given the domestic violence screen and a list of local resources to help if the screen showed evidence of abuse; those who only received the domestic violence resource list; and those who were not screened and received no list.
The women in the computer-based screening/resource list group who confirmed domestic violence by answering yes to at least one question were also shown a brief video which offered information about the hospital-based domestic violence advocacy program. The video also encouraged the patient to seek help.
The researchers re-contacted almost 2,400 of the women one year after the study began, to assess and rate their quality of life, as well as their physical and mental health. They also tracked any recurrence of domestic violence among the women, the number of days they lost from work or were unable to perform household activities, as well as their use of health care and domestic violence services.
The study revealed that after one year, the average quality of life ratings showed no significant difference between any of the women from any of the groups -- including those who were screened.
The researchers also found no differences in the number of missed workdays, hospitalizations, ER visits or contact with partner violence agencies between any of the women in the three groups.
After one year, the study also showed that about 10 percent of women reported experiencing domestic violence in the year before the study began and during the past year. The researchers found no statistically significant difference in recurrence of partner violence between study groups.
"The results of this study suggest providing a partner violence resource list with or without computerized screening of female adult patients in primary care settings does not result in significant benefits in terms of general health outcomes," the study authors concluded. "These findings provide important information for clinicians and others to consider in light of recent professional recommendations calling for routine screening."
Responding to the findings, C. Nadine Wathen, from Western University in London, Ontario, Canada, and Dr. Harriet MacMillan from McMaster University in Hamilton, Ontario, agreed that universal screening may not aid women's health or quality of life and it also may not reduce their re-exposure to domestic violence.
"It is time to enact an approach in which individual women are assessed according to their presenting histories, which include symptoms and risks," Wathen and MacMillan said in a journal news release.
-- Mary Elizabeth Dallas
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