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Screening for Intimate Partner Violence and Abuse of Vulnerable Adults: U.S. Preventive Services Task Force Recommendation FREE

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The full report is titled “Screening for Intimate Partner Violence and Abuse of Elderly and Vulnerable Adults: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 19 March 2013 issue of Annals of Internal Medicine (volume 158, pages 478-486). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.

This article was published at www.annals.org on 22 January 2013.

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Ann Intern Med. 2013;158(6):I-28. doi:10.7326/0003-4819-158-6-201303190-00587
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Who developed these recommendations?

The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that reviews available research and makes recommendations about preventive health care.

What is the problem and what is known about it so far?

Domestic abuse is when a person is physically, sexually, or emotionally abused or physically neglected by a spouse or other intimate partner or an elderly and vulnerable adult is abused by a family member or caretaker. While common, these problems often go undetected, and in addition to causing injury or death, can lead to a variety of medical and mental health problems. Things that should raise a health care provider's suspicion that intimate partner violence or abuse is occurring are repeated or unusual injuries, depression, and unexplained symptoms or absences from school or work. In these situations, doctors should ask patients about family violence. However, it is unclear whether doctors should screen all patients for intimate partner violence and abuse as part of routine health care. Screening is looking for a condition in patients who have no symptoms or signs of that condition.

In 2004, the USPSTF found no sufficient evidence to recommend for or against screening all adult patients for intimate partner violence and abuse. The USPSTF has now updated those recommendations.

How did the USPSTF develop these recommendations?

The USPSTF reviewed published research since 2004 about the benefits and harms of screening for intimate partner violence and abuse of elderly and vulnerable adults. Potential benefits would be decreased disability, injury, or premature death. Potential harms would be an increase in abuse if the victim or someone else confronts the abuser.

What did the authors find?

The USPSTF found good evidence that available screening questionnaires can identify current or past intimate partner violence or risk for it; however, evidence on the accuracy of screening questionnaires to identify abuse in elderly or vulnerable adults is lacking. It found good evidence that interventions can reduce harm to adult women of reproductive age; however, similar evidence was lacking for other vulnerable adults or the elderly. For intimate partner violence, the USPSTF found that the risk for harm from screening was low; however, it did not find adequate evidence that screening for abuse in other vulnerable or elderly adults does not result in increased harm to the abused person.

What does the USPSTF recommend that patients and doctors do?

The USPSTF recommends that doctors and other health care providers screen women of childbearing age for intimate partner violence and refer those who report such violence to services for abused women. These services include support groups, counseling, information cards, and community services.

The USPSTF does not recommend for or against screening for abuse and neglect in elderly and vulnerable adults.

What are the cautions related to these recommendations?

These recommendations apply to screening all people without signs or symptoms of abuse or neglect as part of routine health care. Of course, if a patient presents with signs of abuse or neglect, health care providers should ask about these issues and assist patients in getting help.





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