Physical and social predictors of partner abuse in women attending general practice: a cross-sectional study.

Abstract

BACKGROUND: Intimate partner abuse causes significant morbidity and mortality in women attending general practice. Currently there is insufficient evidence for screening all women but case finding of women at risk of intimate partner abuse is recommended. AIM: To develop physical symptoms and sociodemographic indicators for partner abuse for women attending general practice. DESIGN OF STUDY: Descriptive, cross-sectional survey. SETTING: Thirty general practices in Victoria, Australia. METHOD: A total of 1257 consecutive women attending general practice (response rate 77%) were screened for a history of partner abuse using a self-report questionnaire. The presence of partner abuse in the last 12 months was measured by the Composite Abuse Scale. RESULTS: Women who reported more than two physical symptoms in the last month were more likely to report experiencing partner abuse in the last 12 months (3-5 symptoms, odds ratio [OR]=2.32, 95% confidence interval [CI]=1.55 to 3.48; 6-15 symptoms OR=3.47, 95% CI=2.21 to 5.47). Many individual physical symptoms were associated with partner abuse in the bivariable analysis. Multivariable analysis showed clinical indicators of partner abuse (excluding the strong association with depression) which included sociodemographic features (age, separated/divorced, low education, low income, no private insurance) and physical symptoms (diarrhoea, tiredness, chest pain). CONCLUSION: Clinicians should be alert for current and past partner abuse in women who are separated/divorced, on low incomes, have poor education, or have multiple physical symptoms in the past month. Future research questions include what interventions would work for women who have been or are being abused once identified.