Screening for family and intimate partner violence

We found few studies of screening for elder abuse and neglect. A randomized controlled trial with 15-years follow-up indicated that nurse home visits during pregnancy and for 2-years postpartum for low-income women improved abuse and neglect outcomes for children. Studies of interventions for childr...

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Main Authors: Nelson, Heidi D., Nygren, Peggy (Author), McInerney, Yasmin (Author)
Corporate Authors: Oregon Health & Science University Evidence-based Practice Center, United States Agency for Healthcare Research and Quality
Format: eBook
Language:English
Published: Rockville (MD) Agency for Healthcare Research and Quality (US) 2004, [2004]
Series:Systematic evidence reviews
Subjects:
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Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Summary:We found few studies of screening for elder abuse and neglect. A randomized controlled trial with 15-years follow-up indicated that nurse home visits during pregnancy and for 2-years postpartum for low-income women improved abuse and neglect outcomes for children. Studies of interventions for children of other ages, women who are not pregnant, and elderly adults are lacking. CONCLUSIONS: Screening and interventions for child abuse are directed to parents during prenatal and postpartum periods. Several brief screening instruments have been tested for women, but interventions are lacking. Few instruments and no interventions were identified for elderly adults
CONTEXT: Family and intimate partner violence occurs commonly in the U.S. and causes important health problems. Although the clinician's role in identification and intervention is considered a professional and legal responsibility, the effectiveness of these efforts is unclear. OBJECTIVE: To examine evidence on the performance of screening procedures and interventions in the primary care setting in reducing harm from family and intimate partner violence for children, women, and elderly adults. DATA SOURCES: MEDLINE(r), PsycINFO, CINAHL, Health & Psychosocial Instruments, ERIC, AARP Ageline, and the Cochrane Controlled Trials Register, reference lists of systematic reviews, and experts. STUDY SELECTION: Included studies had English-language abstracts, were applicable to U.S.
clinical practice, described abuse and neglect in women, children, or elderly adults, were conducted in or linked to primary care, obstetrics/gynecology, or emergency department settings, and included a clinician in the process of assessment or intervention. DATA EXTRACTION: We extracted selected information about study design, patient samples and settings, methods of assessment or intervention, and clinical endpointsand applied a set of criteria to evaluate study quality. DATA SYNTHESIS: No studies directly addressed the effectiveness of screening in a healthcare setting in reducing harm, or described the adverse effects of screening and interventions. All instruments designed to screen for child abuse and neglect were directed to parents, particularly pregnant women. These had fairly high sensitivity but low specificity. Several brief instruments designed to identify women with intimate partner violence compared well to longer previously validated instruments.
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