[The S.I.G.N.A.L.-Intervention Project to combat violence against women]. / Das S.I.G.N.A.L.-Interventionsprogramm gegen Gewalt an Frauen.

Domestic violence has profound effects on the health of women. According to the World Health Organization, violence is a significant risk factor for morbidity and mortality in women. If violence is not taken into account as a cause of health problems, there is a high risk of inappropriate health care. More attention to the issue of domestic violence in medical history, diagnosis and therapy is the objective of the "S.I.G.N.A.L. Intervention Project to Combat Violence Against Women". The "S.I.G.N.A.L. Project" is the first intervention project against violence in a medical setting in Germany. It was started in 1999 in the emergency room of Benjamin Franklin University Hospital (Charite Campus Benjamin Franklin). The goal of the project is to initiate prevention and intervention for violence against women by providing the abused women with appropriate support and treatment. The program is based on the intervention objectives: ask about abuse, assess for danger, inform and refer victims to counselling programs and women's shelters, and document injuries and health problems for use in legal proceedings.

[Domestic violence against women and health care demands. Results of a female emergency department patient survey]. / Häusliche Gewalt gegen Frauen und Versorgungsbedarf. Ergebnisse einer Befragung von Patientinnen einer Ersten Hilfe/Rettungsstelle.

Domestic violence (DV) is a serious risk for women's health. So far, little attention has been paid to this area in research and medical care in Germany. Acknowledging this deficit, the S.I.G.N.A.L.-Intervention Project has started to develop a program to improve the medical care for victimized women. For the first time in Germany, data on the health care needs of victimized women have been collected within the S.I.G.N.A.L.-Evaluation Research Project. This article presents the results of a female patient survey (n=806) on DV conducted in the emergency department (ED) of a university hospital in Berlin. The results demonstrate that 36.6% of women reported at least one episode of DV after the age of 16. A total of 4.6% were victims of DV over the past year, and 1.5% of women came to the ED for treatment of injuries caused by violence. A total of 57% of the victims of at least one episode of DV in their lifetime after the age of 16 described a negative impact on their health. The most frequently reported sequelae were head injuries, haematomas and fractures, gastrointestinal disorders, headache/migraine and heart disease. The psychological symptoms were anxiety, depression and suicide/self-mutilation attempts. Some 52% of the victims who reported health consequences had received medical care. In case of DV occurring, 67% of all women said that they would discuss it with their physicians. Approximately 80% of all respondents favoured a routine inquiry for DV as part of the medical history protocol of the ED.

[Domestic violence against women: health consequences and need for care--results of a survey among first-aid-patients in the framework of the S.I.G.N.A.L.- accompanying research]. / Häusliche Gewalt gegen Frauen: Gesundheitsfolgen und Versorgungsbedarf - Ergebnisse einer Befragung von Erste-Hilfe-Patientinnen im Rahmen der S.I.G.N.A.L.-Begleitforschung.

UNLABELLED: To determine the prevalence of domestic violence (DV), sequelae, and the expectancies of support/intervention among female patients receiving medical care within an emergency department (ED), a pertinent inquiry was effected. METHOD: Cross-sectional survey, using trained female interviewers to confidentially administer standardised questionnaires to female patients of the ED of a university hospital in Berlin, Germany. There were 1557 female patients, 18 to 60 years of age, receiving medical care in a hospital ED during 7 weeks in the Spring/Summer of 2002. Of that initial population, 411 women were excluded, 340 refused participation, with N = 806 (70 %) participating in the study. The survey instrument included questions on different kinds of abuse, sequelae (physical and mental), demographic characteristics and the patients' expectations of support by health professionals. RESULTS: 57 % of the victims of at least one episode of DV in their lifetime after the age of 16 claimed health consequences. According to the percentage of nominations the sequelae were: mental (54 %), physical (35 %), 32 % both, head injuries (60 %), haematomas/bruises (44 %), and fractures (17 %), injuries from stabbings, gunshots, or burns (10 %), gastrointestinal disorders (23 %), headache/migraine (18 %), and heart disease (15 %). The most frequently reported psychological symptoms were anxiety (32 %), depression (13 %) and suicide/self-mutilation attempts (5 %). 52 % of the victimised women, who reported health consequences, had received medical care in lifetime including: 33 % surgery, 24 % emergency department, and 10 % received clinical treatment. In response to a hypothetical question about a future incidence of DV victimisation posed to all respondents, 67 % claimed that they would discuss it with their physicians, and only 8 % of respondents indicated that they had ever been asked about DV occurrence during any past consultations with a health care professional. Approximately 80 % of all respondents favour a routine inquiry for DV to be included as part of the medical history protocol of the ED. CONCLUSION: The sequelae resulting from DV victimisation of women receiving medical services, suggests the need for intervention(s) within the health care setting. Health professionals must first acknowledge DV as a possible cause of injuries and other health disorders in female patients. Domestic violence screening of female patients within the health care setting can enhance the quality of care for victims. Women's expectations show the acceptability of such interventions.