Overcoming the barriers to disclosure and inquiry of partner abuse for women attending general practice.

OBJECTIVES: To determine the barriers to and rates of disclosure of partner abuse by women attending GPs.
METHODS: In a qualitative study, abused Melbourne women were interviewed about their experiences with GPs. Following this, adult women attending a random sample of Brisbane general practices were surveyed. Multivariate analyses were conducted on the data, using levels of disclosure and GP inquiry adjusting for cluster effect to obtain prevalence rate ratios.
RESULTS: Thirty-seven per cent of the survey participants (n=1836, response rate 78.5%) admitted to having ever experienced abuse in an adult intimate relationship. One-third (36.7%) of these abused women (n=674) had ever told a GP and 87.8% had never been asked by their GP about partner abuse. Women who disclosed were almost twice as likely than women who have not: to be middle aged, have experienced combined physical, emotional and sexual abuse and be afraid of their partner. They were more than twice as likely to have been asked about abuse. A GP's good communication skills facilitated disclosure. The main barriers to disclosure were that women saw the problem as their own i.e. internal barriers. The data from the qualitative study (n=20) are used to illustrate these findings.
CONCLUSION: Educational interventions that improve GPs' communication skills might result in increased disclosure and early intervention in partner abuse. GPs need sensitive attitudes, greater skills, knowledge and support to manage the consequences of disclosure.