Women’s College Hospital in Toronto hosts the Domestic Violence Education Program ( ), with online, self-paced modules to achieve competency in clinically relevant aspects of IPV. 8 REAL Talk ( ) is an Alberta initiative that provides online training and workshops for health practitioners and the public to help recognize, empathize, ask and listen to individuals who have experienced IPV. The EDUCATE program ( is a multimodal training platform that provides resources for orthopedic surgeons and other practitioners working with patients who present with trauma in order to promote knowledge and comfort with IPV identification and support. Validated tools and resources exist to support physicians in initiating new IPV identification and support practices and programs where none exist currently. The American College of Surgeons Statement on IPV calls on surgeons “not only to care for our patient’s immediate injuries, but also to refer patients to appropriate resources and follow-up for IPV.” 10 The Canadian and American Orthopaedic Associations also encourage members to take steps to educate themselves about IPV, identify IPV and offer patient assistance. 9 The onus is on health practitioners to begin the conversation with patients who may have experienced IPV. 9 Most women do not offer relevant information themselves. 9 For patients in whom the health care practitioner suspects IPV, best evidence supports direct questioning about IPV in a private environment. 3 Unfortunately, only 14% of patients presenting to health care practitioners with IPV-related injuries are asked questions to identify IPV and initiate support. Head and neck trauma and upper extremity injuries are the most common physical health care presentations related to IPV. 8 Because of discrimination or prejudgment, individuals who have experienced IPV may be overlooked. 4, 9 However, IPV affects all races, ethnicities, socioeconomic strata, ages and relationship statuses. Identified risk indicators for IPV include lower socioeconomic status, inadequate social supports, low education level, substance abuse, mental illness, younger age, unintended pregnancy, financial dependency and employment status. 8 Of women murdered by their intimate partner, 45% presented to a health care professional for treatment of an IPV injury in the 2 years before their death. One in 3 women presenting to the emergency department after a trauma have been injured by their partner, and 1 in 6 women presenting to an orthopedic fracture clinic have experienced IPV in the previous 12 months. 7 Health care professionals frequently encounter victims of IPV. 2 Worldwide, a woman is killed by their intimate partner every 6 days. ![]() 3 Even in the absence of a public health emergency, women have a 30% estimated lifetime prevalence of physical and sexual IPV. Intimate partner violence is already the most common cause of nonfatal injury to women worldwide. 7 Health care providers, although facing the need to learn many new skills related to COVID-19, must also maintain awareness of IPV, seek opportunities for self-education, develop strategies for discussing IPV and become familiar with currently available local resources for patient referral. In Ontario, the York and Durham Regional Police Departments reported a 22% increase in domestic incidents and sexual assault reports. In Canada, calls to the Vancouver Battered Women’s Support Services have tripled, 6 while in Alberta, specialized crisis lines for IPV have seen a 30%–50% increase in calls. 5 Areas of the United Kingdom and France have seen increases of 20% and 30%, respectively, in police reports regarding IPV. 3, 4ĭuring their recent lockdowns, China, Italy and Spain reported a substantial increase in calls to IPV emergency support lines. 2 The stress of confinement, financial uncertainty, attitudes about gender roles and a desire for control during disasters all contribute to an increased risk of IPV. ![]() 1 Measures to minimize the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinforce environments that facilitate behaviours used by one person within an intimate relationship to exert power over and inflict physical, psychological or sexual harm on another. 27, 2020, the United Nations issued a statement warning that rates of widespread intimate partner violence (IPV) will increase owing to the coronavirus disease 2019 (COVID-19) pandemic, including intimate partner femicides. ![]() ![]() Validated online resources are available to help health care providers increase their knowledge and comfort with identification and support for patients experiencing IPV.
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