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Clinical Orthopaedics and Related Research®

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01-04-2013 | Clinical Research

Orthopaedic Surgeons’ Knowledge and Misconceptions in the Identification of Intimate Partner Violence Against Women

Authors: Gregory J. Della Rocca, MD, PhD, FACS, Sheila Sprague, MSc, Sonia Dosanjh, MSW, Emil H. Schemitsch, MD, FRCS(C), Mohit Bhandari, MD, PhD, FRCS(C)

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2013

Abstract

Background

Intimate partner violence (IPV)—physical, sexual, psychologic, or financial abuse between intimate partners—is the most common cause of nonfatal injury to women in North America. As many IPV-related injuries are musculoskeletal, orthopaedic surgeons are well positioned to identify and assist these patients. However, data are lacking regarding surgeons’ knowledge of the prevalence of IPV in orthopaedic practices, surgeons’ screening and management methods, and surgeons’ perceptions about IPV.

Questions/purposes

We aimed to identify (1) surgeon attitudes and beliefs regarding victims of IPV and batterers and (2) perceptions of surgeons regarding their role in identifying and assisting victims of IPV.

Methods

We surveyed 690 surgeon members of the Orthopaedic Trauma Association. The survey had three sections: (1) general perception of orthopaedic surgeons regarding IPV; (2) perceptions of orthopaedic surgeons regarding victims and batterers; and (3) orthopaedic relevance of IPV. One hundred fifty-three surgeons responded (22%).

Results

Respondents manifested key misconceptions: (1) victims must be getting something out of the abusive relationships (16%); (2) some women have personalities that cause the abuse (20%); and (3) the battering would stop if the batterer quit abusing alcohol (40%). In the past year, approximately ½ the respondents (51%) acknowledged identifying a victim of IPV; however, only 4% of respondents currently screen injured female patients for IPV. Surgeons expressed concerns regarding lack of knowledge in the management of abused women (30%).

Conclusion

Orthopaedic surgeons had several misconceptions about victims of IPV and batterers. Targeted educational programs on IPV are needed for surgeons routinely caring for injured women.

American Academy of Orthopaedic Surgeons. Advisory statement - Domestic and family violence and abuse: the orthopaedic surgeon’s responsibilities. Document 1030. Available at: http://www.aaos.org/about/papers/advistmt/1030.asp. Accessed October 18, 2012.

American Academy of Orthopaedic Surgeons. Family violence state statutes. Available at: http://www.aaos.org/about/abuse/ststatut.asp. Accessed October 18, 2012.

Bhandari M, Dosanjh S, Tornetta P 3rd, Matthews D; Violence AgainsWwomen health Research Collaborative. Musculoskeletal manifestations of physical abuse after intimate partner violence. J Trauma. 2006;61:1473–1479.PubMedCrossRef

Bhandari M, Sprague S, Dosanjh S, Petrisor B, Resendes S, Madden K, Schemitsch EH; P.R.A.I.S.E. Investigators. The prevalence of intimate partner violence across orthopaedic fracture clinics in Ontario. J Bone Joint Surg Am. 2011;93:132–141.PubMedCrossRef

Bhandari M, Sprague S, Tornetta P 3rd, D’Aurora V, Schemitsch E, Shearer H, Brink O, Mathews D, Dosanjh S; Violence Against Women Health Research Collaborative. (Mis)perceptions about intimate partner violence in women presenting for orthopaedic care: a survey of Canadian orthopaedic surgeons. J Bone Joint Surg Am. 2008;90:1590–1597.PubMedCrossRef

Borkowski M, Murch M, Walker V. Marital Violence: The Community Response. London, UK: Tavistock; 1983;115–125.

Canadian Orthopaedic Association. Intimate partner violence: position statement. 2009. Available at: http://www.coa-aco.org/library/health-policy/intimate-partner-violence.html. Accessed October 18, 2012.

Chambliss LR, Bay RC, Jones RF 3rd. Domestic violence: an educational imperative? Am J Obstet Gynecol. 1995;172:1035–1038.PubMedCrossRef

Dannenberg AL, Baker SP, Li G. Intentional and unintentional injuries in women: an overview. Ann Epidemiol. 1994;4:133–139.PubMedCrossRef

10.

Dobash RE, Dobash R. Violence Against Wives: A Case Against the Patriarchy. New York, NY: Free Press; 1979:179–206.

11.

Easteal PW, Easteal S. Attitudes and practices of doctors toward spouse assault victims: an Australian study. Violence Vict. 1992;7:217–228.PubMed

12.

Fishman PA, Bonomi AE, Anderson ML, Reid RJ, Rivara FP. Changes in health care costs over time following the cessation of intimate partner violence. J Gen Intern Med. 2010; 25:920–925.PubMedCrossRef

13.

Gutmanis I, Beynon C, Tutty L, Wathen CN, MacMillan HL. Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses. BMC Public Health. 2007;7:12.PubMedCrossRef

14.

Kyriacou DN, Anglin D, Taliaferro E, Stone S, Tubb T, Linden JA, Muelleman R, Barton E, Kraus JF. Risk factors for injury to women from domestic violence against women. N Engl J Med. 1999;341:1892–1898.PubMedCrossRef

15.

Maiuro RD, Vitaliano PP, Sugg NK, Thompson DC, Rivara FP, Thompson RS. Development of a health care provider survey for domestic violence: psychometric properties. Am J Prev Med. 2000;19:245–252.PubMedCrossRef

16.

McCloskey LA, Lichter E, Ganz ML, Williams CM, Gerber MR, Sege R, Stair T, Herbert B. Intimate partner violence and patient screening across medical specialties. Acad Emerg Med. 2005;12:712–722.PubMedCrossRef

17.

Narayan AP, Socolar RR, St Claire K. Pediatric residency training in child abuse and neglect in the United States. Pediatrics. 2006;117:2215–2221.PubMedCrossRef

18.

National Center for Injury Prevention and Control. Costs of Intimate Partner Violence Against Women in the United States. Atlanta, GA: Centers for Disease Control and Prevention; 2003.

19.

Parsons LH, Zaccaro D, Wells B, Stovall TG. Methods of and attitudes toward screening obstetrics and gynecology patients for domestic violence. Am J Obstet Gynecol. 1995;173:381–386; discussion 386–387.PubMedCrossRef

20.

Plichta SB, Falik M. Prevalence of violence and its implications for women’s health. Womens Heath Issues. 2001;11:244–258.CrossRef

21.

Prosman GJ, Lo Fo Wong SH, Bulte E, Lagro-Janssen AL. Healthcare utilization by abused women: a case control study. Eur J Gen Pract 2012;18:107–113.PubMedCrossRef

22.

Reid SA, Glasser M. Primary care physicians’ recognition of and attitudes toward domestic violence. Acad Med. 1997;72:51–53.PubMedCrossRef

23.

Rodriguez MA, Bauer HM, McLouglin E, Grumbach K. Screening and intervention for intimate partner abuse: practices and attitudes of primary care physicians. JAMA. 1999;282:468–474.PubMedCrossRef

24.

Roelens K, Verstraelen H, Van Egmond K, Temmerman M. A knowledge, attitudes, and practice survey among obstetrician-gynaecologists on intimate partner violence in Flanders, Belgium. BMC Public Health. 2006;6:238.PubMedCrossRef

25.

Rose K, Saunders DG. Nurses’ and physicians’ attitudes about women abuse: the effects of gender and professional role. Health Care Women Int. 1986;7:427–438.PubMedCrossRef

26.

Shearer HM, Forte ML, Dosanjh S, Mathews DJ, Bhandari M. Chiropractors’ perceptions about intimate partner violence: a cross-sectional survey. J Manipulative Physiol Ther. 2006;29:386–392.PubMedCrossRef

27.

US Department of Justice, Federal Bureau of Investigation. Crime in the United States: uniform crime reports. 1997. Available at: http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/1997/toc97.pdf. Accessed October 18, 2012.

28.

Waalen J, Goodwin MM, Spitz AM, Petersen R, Saltzman LE. Screening for intimate partner violence by health care providers: barriers and interventions. Am J Prev Med. 2000;19:230–237.PubMedCrossRef

Title: Orthopaedic Surgeons’ Knowledge and Misconceptions in the Identification of Intimate Partner Violence Against Women
Authors: Gregory J. Della Rocca, MD, PhD, FACS
Sheila Sprague, MSc
Sonia Dosanjh, MSW
Emil H. Schemitsch, MD, FRCS(C)
Mohit Bhandari, MD, PhD, FRCS(C)
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 4/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2749-x

At a glance: The STEP trials

Springer Medicine

Orthopaedic Surgeons’ Knowledge and Misconceptions in the Identification of Intimate Partner Violence Against Women

Abstract

Background

Questions/purposes

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusion

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