In Brief

Fear of offending patients, a lack of clinical skills and feelings of helplessness are keeping health-care providers from identifying victims of domestic violence, a group of health-care researchers report. But health-care providers can become more confident in their assessments of patients who may be domestic violence victims after receiving just three hours of training, the researchers say.

The study, "Evaluation of a health-care provider training program to identify and help partner violence victims," was conducted by L. Kevin Hamberger, PhD, at the Medical College of Wisconsin and colleagues. They found that giving health-care providers didactic information about domestic violence as well as role modeling and skill rehearsal increased their perceived judgments of self-efficacy in screening and helping victims. Increasing self-efficacy may be an important precursor to increased screening and helping behavior, the researchers say.

In the study, 752 physicians, nurses, certified medical assistants, radiology technicians, laboratory technicians and social workers from a variety of departments provided pre-workshop information on previous domestic violence training, whether they routinely asked patients about violence in their relationships and what their sense of efficacy was in domestic violence screening. Forty-eight percent of participants reported some prior type of domestic violence intervention training and 25 percent reported identifying a partner violence victim in the past year.

Participants were surveyed again immediately after the workshop. Those without prior training or experience with battered victims reported significant increases in self-efficacy as well as referral and screening abilities. Individuals who had previous training or experience also reported increased self-efficacy, although the change was substantially less than the inexperienced participants.

In addition, participants from specialties such as surgery, intensive care/critical unit, internal medicine, cancer care and medical/surgery reported a greater increase than those from emergency departments. Emergency department personnel may have had greater familiarity and prior exposure to training and calls to action, and therefore exhibited a "ceiling effect" from training, the researchers say.

A third of the participants were randomly selected to complete a six-month follow-up survey. All measures remained significantly higher at follow-up compared to pre-workshop assessments. However, self-efficacy, referral and screening skill confidence all dropped significantly between the post-workshop survey and the six-month follow-up.

Taken as a whole, the data suggest that domestic violence training increases health-care providers' judgments of self-efficacy and other attitudes thought to be important in identifying and helping victims.

The researchers caution, though, that the data also suggest single-session or one-time training programs may need to be supplemented with ongoing booster, in-service training programs to reinforce self-efficacy and comfort in identifying and helping victims.

--D. SMITH