A Comparison of Domestic Violence Screening, Attitudes, and Knowledge Base

Objective: To compare advanced practice nurses\u27 (APNs) and physicians\u27 (MDs) domestic violence screening behaviors, perceived obstacles, and knowledge base so as to determine the efficacy of the collaborative practice model of care. Design: The survey questionnaires were the Nurse Practitioners\u27 Experience with Partner Abuse in Alaska and the Physicians\u27 Experience with Partner Abuse in Alaska . Significant differences were evaluated by using one-way analysis of variance (ANOVA). Setting: Two 200-300 bed urban HMO medical centers. Participants: Thirty-five providers (23 MDs and 12 APNs) with the mean age of 40, and with 8 years clinical practice in California. Results: Of total providers, 47% estimated domestic violence occurred in\u3c 5% of patients. APNs exhibited better screening at initial visits, regular, and annual exams. MDs exhibited better screening when patients present injured. Frustration and resource availability were identified as obstacles to screening. MDs considered a patient\u27s right to privacy important. Conclusions: Domestic violence incidence is underestimated. APNs exhibited better primary and secondary prevention. MDs exhibited better tertiary care. Frustration and resource availability are difficult for nurses, privacy issues difficult for MDs. Collaborative practice would combine the strengths of both professions providing appropriate domestic violence care