Intimate partner violence screening in the emergency department: U.S. medical residents' perspectives.

Intimate Partner Violence (IPV) is physical, psychological, or sexual harm committed by a current or former partner, spouse, boy/girlfriend. In the United States, the National Center for Injury Prevention and Control (2003) estimates that 1.5 million women experience physical assault each year while the lifetime prevalence rate of IPV for women reaches almost 30%. Given the frequency and range of injuries and other health-related problems that result from IPV, the medical system shows promise as a central source of service provision for large numbers of abused women and their children. However, identification rates of IPV in many medical settings are low. This article describes a study that examined focus group data from 25 physicians in residency training at an urban hospital in the United States. Physicians discussed their knowledge and attitudes about IPV screening in the emergency department (ED) setting and suggestions to address perceived barriers to such screening. These data depict multiple barriers to physician screening of IPV in the ED. Findings substantiate previous research and provide new direction for enhancing IPV identification, referral, and treatment mechanisms in the ED setting including alternatives to physician mandated universal screening.

Intimate partner violence among midlife and older women: a descriptive analysis of women seeking medical services.

Although intimate partner violence (IPV) may occur throughout a woman's life course, there has been a paucity of research on the experiences of victimization among midlife and older women. This article examines both the prevalence of IPV among a sample of women ages 50 to 64 (N=620), who were recruited at an emergency department and primary care clinics in an urban setting, and the associated factors for the subsample of these women who reported IPV (n=34). More than 5 percent of the women reported experiencing some form of abuse by their partners within the past two years. Bivariate analyses comparing victims and nonvictims indicate that higher proportions of women who reported abuse had received public assistance and had a recent history of homelessness. In addition, victims of IPV reported higher frequencies of HIV risk factors than did nonvictims, including having a partner who insisted on sex without a condom, having sex with a man they knew or suspected was an IV drug user, and experiencing symptoms or receiving a diagnosis or treatment for a sexually transmitted infection. Significantly higher percentages of abused women reported being tested for HIV and being HIV seropositive. Implications of the findings for social workers are discussed.

Predictors of condom use and HIV testing among midlife and older women seeking medical services.

OBJECTIVE: This study examines correlates and predictors of sexual HIV risk reported by a sample of midlife and older women (M age = 56.01 years, SD = 4.34). METHODS: In sum, 1,280 participants were recruited from primary health clinics and a hospital emergency department. RESULTS: Of those women in a heterosexual relationship (n = 623), 73% reported having vaginal sex in the past 6 months. Only 12% of these women reported always using a condom during vaginal sex; 45% reported having been tested for HIV. Logistic regression analyses revealed that condom use is associated with more education, being employed, living with a partner, and being HIV positive. HIV testing is associated with being younger, unemployed, and not living with a partner. DISCUSSION: These results (a) demonstrate that midlife and older women are at risk for HIV/AIDS and (b) contribute to a growing understanding of the risk picture involved with such women.

Talking cancer, saving lives: breast cancer awareness training for health professionals in Hong Kong.

A two-day training program aimed at promoting breast cancer awareness and utilization of breast cancer screening in Hong Kong was presented to a group of breast cancer survivors and mid-level health and social services professionals (n = 75). Using a training of trainer model, six modules were presented covering biological, psycho-social, sexual, and quality of life issues relating to breast cancer. Self-administered pre-test, post-test, and follow-up measures were used to determine participants' knowledge about breast cancer related issues and their self-perceived competence to discuss these issues professionally. The participant demographic profile was primarily female, mostly married with mean age of 38. Most of the participants attributed the causes of breast cancer to genetic, lifestyle risk, and environmental risk factors (over 60%). Their attitude, on average, was most positive regarding the difference between a support group and psychoeducational support group (M > 8 on a 0-10 scale). Their knowledge, on average, was lowest regarding familiarity with the types and uses of alternative medicine in Hong Kong (M < 5 on a 0-10 scale). Paired t-tests comparing pre-test to the first post-test indicated a statistically significant increase in composite scores of competence, cause recognition, and suggested frequency of breast self-exam. This training proved to be a culturally competent approach that facilitates health care providers' service provision to breast cancer survivors in Hong Kong.

Considering HIV risk and intimate partner violence among older women of color: a descriptive analysis.

This study describes the types of intimate partner violence (IPV) and sexual HIV-risk factors reported by a sample of 139 African American and Latina women ages 50 and older receiving care in outpatient clinics of an urban medical center. Additionally, we obtained estimates of the associations between experiencing IPV in a primary heterosexual relationship and the following HIV-risk behaviors among our sample of older minority women: (a) having multiple sexual partners, (b) STD history, (c) partner-related risk (i.e., having a partner who has multiple sexual partners, is HIV-infected, injecting drugs, and/or has an STD), and (d) self-perception of risk for HIV infection. Results indicate that many of these women are engaged in sexual risk behaviors, and such behaviors are associated with increased likelihood of IPV for this cohort. Implications for health care professionals are discussed.

A follow-up study of women with cancer: their psychosocial well-being and close relationships.

The psychological and social consequences of having a diagnosis of cancer can continue beyond the initial year of diagnosis. However, very few empirical studies examine the long-term adjustment of cancer survivors and the factors that promote survivors' well-being. This paper presents an 18 month follow-up study of 26 women who were treated for various types of cancer at a major medical center in the United States. They completed questionnaires during the initial treatment phase of the illness and 18 months later. The questionnaire consisted of standardized scales measuring relationship factors (i.e., mutuality, silencing-the-self schemas, and relationship-focused coping) and psychosocial well-being (i.e., quality of life, depression, self-care agency). The results of the follow-up study revealed that the women's psychosocial well-being changed for the better between Time 1 and Time 2, while their relationship factors remained constant. Only one relational factor, silencing-the-self beliefs, at Time 1, was significantly correlated with a well-being variable at Time 2. However, relationship factors at Time 2 were significantly correlated with psychosocial well-being at Time 2, indicating that relational factors continue to play a significant role in the sample's psychosocial adjustment.