Domestic violence among family practice patients in midsized and rural communities.

BACKGROUND: This study was designed to determine the prevalence and character of domestic violence among female patients at three family practice clinics (FPCs) in communities of varying sizes.
METHODS: Structured interviews with 127 consecutive, consenting women were conducted in three FPCs in midwestern communities with populations of 85,000, 8000, and 3000. The main outcome measures included patient self-reports of emotional, social, physical, and sexual violence, and reasons for their clinic visit.
RESULTS: Women at the clinics in the smaller communities were significantly older, reflecting their communities' demographics. Fewer women in the larger community than in the rural settings reported currently having a violent partner (12% vs 25%, P = .01). In the total sample, 46% reported violence from a previous or current partner. Emotional and social abuse were associated with moderate violence (eg, slapping and pushing), severe violence (eg, punching and kicking), and use of weapons. Sexually abused women were emotionally abused and often physically battered. Forty-six percent of currently battered women reported abuse at least once a week, and most (81%) visited their respective clinics for episodic care.
CONCLUSIONS: Domestic violence is a prevalent health problem in all family practice settings. The finding that women in the larger community were less likely to be in a current battering relationship may reflect the effectiveness of local intervention programs. Because battered women present primarily for episodic care, physicians should routinely screen for battery, provide education about violence, assess the danger, review safety plans, and refer women appropriately.