Domestic Violence and the ED: AENJ Hot Topic #FOANed

Editor’s Note: In a second installment from newly appointed Associate Editor and author, Wayne Varndell presents a snapshot of a current political and social priority and how it relates to those working in Emergency Care. Periodically the Australian Emergency Nursing Journal intend to release a number of “Hot Topic” publications from recent and older journal issues as Free Open Access articles. Due to a dearth of high-quality free accessible literature to support nursing practice, Wayne will bring us a round-up each time a new “Hot Topic” release occurs. Once again by way of disclosure, no member of the editorial team receives any incentives from AENJ and these blogs are intended to promote quality evidence based nursing materials to a wider readership.

Domestic violence is a pervasive, global problem of serious proportion. In Australia, the majority of dangerous, abusive and violent behaviour that occurs in the privacy of people’s homes is committed by men against women, with one woman dying per week.¹ Men experience dangerous, abusive and violent behaviour, with one man every ten days dying in Australia.² A study in Victoria found that deaths from intimate partner violence made up 2.3% and 12.9% (femicide and suicide, respectively) of the disease burden, and at the time of the report, intimate partner violence represented a greater disease burden than many well-known risk factors such as high blood pressure, smoking and obesity (Figure 1).³

Figure 1: Top eight risk factors contributing to the disease burden in women aged 15-44 years, Victoria, Australia, 2001.

As one of the primary health services, the emergency department is frequently used by those in a violent relationship, and is commonly seen as the first point of refuge. However, victims of intimate partner violence may be reluctant to disclose the violence unless asked directly by clinicians. Despite valid and reliable screening tools being available,⁴ routine screening for intimate partner violence in the ED setting is low, contrary to evidence suggesting that when asked directly, a significant number of victims disclose the violence.^{5, 6} While intimate partner violence against women has become more known and studied, more research and action is needed regarding male victims of intimate partner violence.

The emergency department is for many people, the first and often continuing point of medical assistance and safety. Intimate partner violence remains one of the greatest disgraces in Australia. Through increased awareness, screening and early intervention it can be dramatically improved. The Australasian Emergency Nursing Journal is pleased to provide open-access to essential content on ways and means to improve identifying and responding to victims of intimate partner violence within the ED setting:

• Domestic violence screening in Emergency Departments: What does it mean for women? By Laura Bahnisch, Charmaine Power, Judith Dwyer, Janny Maddern, Debbie McCarthy, Jane Koziol-McLain
• Factors to consider for family violence screening implementation in New Zealand emergency department. By Karen Schimanski, Bronwyn Hedgecock
• An early identification and intervention model for domestic violence. By Clair Ramsden, Michelle Bonner
• Collaborative team approach to the early identification of domestic and family violence in an ED. By Natalie Retallick, Deb McCarthy

References

1. White Ribbon. Why is the work of White Ribbon important? 2015 [cited 2015 November]; Available from: http://www.whiteribbon.org.au/white-ribbon-importance.
2. Dutton, D. and Nicholls, T., The Gender Paradigm in Domestic Violence Research and Theory: Part 1—The Conflict of Theory and Data. Aggression and Violent Behavior, 2005. 10(6): p. 680-714.
3. Victorian Health, The health costs of violence: Measuring the burden of disease caused by intimate partner violence – a summary of findings., Department of Human Services: Victoria.
4. Rabin, R., Jennings, J., and Bair-Merritt, M., Intimate partner violence screening tools. American Journal of Preventative Medicine, 2009. 36(5): p. 439-445.
5. Schimanski, K. and Hedgecock, B., Factors to consider for family violence screening implementation in New Zealand emergency departments. Australasian Emergency Nursing Journal, 2009. 12: p. 50-54.
6. Ramsden, C. and Bonner, M., An Early Identification and Intervention Model for Domestic Violence. Australasian Emergency Nursing Journal, 2009. 5(1): p. 15-20.