Nashville – Primary care providers are often the first point of contact for survivors of intimate partner violence (IPV) and should be prepared to recognize the signs, according to a speaker at the American Association of Nurse Practitioners 2014 meeting.
Nearly 40% of women and 30% of men experience physical violence from domestic disputes, but only 21% of female and 6% of male victims inform a healthcare provider, Leslie K. Robbins, PhD, RN, PMHNP/CNS-BP, associate professor and assistant dean for graduate education at the University of Texas El Paso, reported.
Robbins stressed the importance of disavowing the treatment of IPV with common myths, namely that such abuse only occurs in relationships involving poor women or women of color, and that the issue be relegated as a personal problem between the abuser and victim.
On the contrary, IPV is as widespread and statistically significant as ever in both men and women, owing to billions of dollars in healthcare costs. Nearly 10% of women (11.2 million total) in the U.S. have been raped by their partners, with about 16% of women (19 million) and 8% of men (9 million) experiencing sexual violence of some kind. In 2010, about 13% of all violent crimes (509,230 total) were cases of IPV.
The problem is not endemic to the U.S. alone. Up to 70% of women in the world have been physically assaulted by their partners, and 40% to 70% of female murder victims in 2013 were killed by their spouses or boyfriends, according to WHO.
Although the actual number of men who experience IPV is unknown, Robbins said that latest estimates suggest about 800,000 men are abused by their wives or girlfriends. However, because of social constructs – such as male victims feeling that nobody will believe them – most cases go unreported.
Robbins advised that healthcare providers be non-judgmental and supportive in first-line treatment, with a focus on being practical, inquiring and providing social support when needed.
Currently, only about 20% of healthcare professionals screen their patients for IPV. Since the incidence of IPV is so common and only made worse social barriers that normalize abuse, Robbins suggested that all healthcare providers screen their patients for IPV.
Providers should at least make an effort to clinically inquire on the possible incidence of partner abuse with patients when assessing conditions that may be caused by or complicated by IPV. These include depression, post-traumatic stress, sleep disorders, suicidal tendencies, signs of sexual or genitourinary dysfunction, genital bleeding, or repeated health consultations without any clear diagnosis.
Patients who are identified as being in an abusive relationships should be given first-line support – “psychological first-aid,” according to Robbins – for the treatment of any possible health concerns.
Sexual assault victims should be carefully treated within five days with first-line treatment, contraception, and psychological intervention. Follow-up should be performed for three months thereafter.
Recommended therapies for women who are no longer in an abusive relationship but who are displaying PTSD symptoms include cognitive behavioral therapy and eye movement desensitization and reprocessing with the consultation of a psychiatrist.