Domestic violence in the emergency department: how do women prefer to disclose and discuss the issues?

The purpose of this study was to survey women presenting to the emergency department (ED) and determine from them how best to identify and discuss issues of domestic violence (DV). An anonymous 10-question survey was given to ambulatory females presenting to the ED. It was conducted at two affiliated university hospital EDs, one an urban trauma center (ED 1) and the other an ED in an affluent suburban setting (ED 2). Two hundred forty-three women responded (73% response), 153 (63%) from ED 1 and 90 (37%) from ED 2. There were 21 women (9%) currently being abused, and 109 (45%) were past victims. Of all victims, 40 (36%) would only divulge DV if asked directly, 28 (25%) would volunteer this information without being asked, and 12 (11%) would not report DV even if asked. Of women who would reveal DV only if asked directly, 52 (45%) felt very comfortable disclosing this to an ED physician, although only 27 (24%) would reveal DV at a triage encounter. Of past or current victims, 43 (39%) would not disclose DV if they knew that ED personnel were required to report it. In conclusion, the ED is an appropriate setting to discuss DV issues. A significant percentage of women will disclose DV only if asked directly about it. Many victims of DV feel very comfortable discussing DV with ED physicians and nurses, although they may be less likely to reveal DV incidents at a triage encounter. Mandatory reporting laws may be an impediment to identifying cases of abuse.