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Screening for family violence in fourth trimester (EPOSTER: 5mins)

Presentation Description

Background: Domestic Violence (DV) in Australia is a key contributor to illness, disability and mortality of women aged 18-44 years1. The times when a woman is at the greatest risk for DV include are when she leaves the relationship and during the perinatal period2. Western Australia has the second highest rate of sexual and physical abuse against women in Australia3. The 6-8-week postpartum check is the best time to screen high-risk women who may otherwise not reach out for support. Universal screening for DV has been found to increase the number of disclosures by women and allows for GPs to take steps towards a tailored approach for supporting a victim4. 
 
Method: Retrospective clinical audit. Study dates: 01/01/201931/12/2019). This audit was conducted in a WA outer metropolitan GP practice. 
 
Results: DV screening was conducted in 49% (n=55) of sample size presenting for the post-partum 6-8-week check. In contrast, 36% (n=55) were not screened and 15% were unable to be screened with a reason documented in the patient notes. 
 
Discussion: The perinatal period is a time when domestic violence (DV) can commence, or escalate if previously occurring. Women are more likely to disclose to their GP if explicitly asked about DV. It is recommended that GPs screen every woman at the 6-8-week check and during the womans fourth trimester. This audit found that only 49% of women were screened for DV (Outer metropolitan GP, WA) warranting the need to implement strategies for improving the proportion that are screened. 
 
Implications for practice: Particularly in light of the evolution of COVID-19 and the implications of social isolation, the risk of DV has increased in our community. The 6-8-week check is an opportune time to ask about DV as women are more likely to have increased contact with their GP around this time of increased risk and dual vulnerability. References: Australias National Research Organisation for Womens Safety. (2016). Examination of the Burden of Disease of Intimate Partner Violence against Women in 2011: Final Report. Retrieved from https://d2rn9gno7zhxqg.cloudfront.net/wp-content/uploads/2019/02/ 19024712/ BoD-Horizons.pdf. Royal College of General Practitioners. (2014). Abuse and Violence: Working with Our Patients in General Practice, 4th edn. Retrieved from https://www.racgp.org.au/FSDEDEV/media/ documents/ Clinical%20Resources/Guidelines/Whitebook/Abuse-and-violence-working-with-our-patients-in-general-practice.pdf. Australian Bureau of Statistics. (2012). Personal Safety Survey CAT no 4906.0. Retrieved from https://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4906.0Main+Features12012?OpenDocument. O'Doherty, L. J., Taft, A., Hegarty, K., Ramsay, J., Davidson, L., & Feder, G. (2014). Screening women for intimate partner violence in healthcare settings: Abridged Cochrane systematic review and meta-analysis. BMJ, 348, 2913. https://doi.org/10.1136/bmj.g2913.

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