Primary care and victims of domestic violence

Interpersonal violence amongst primary health care patients in Lesotho: A qualitative study of the reasons for assault

Background

Interpersonal violence is a common cause of morbidity and mortality. The incidence of and weapons used in interpersonal violence vary amongst countries and may even vary within regions of a country. Substance abuse, including alcohol, has been linked to interpersonal violence, but other socio-economic factors, cultural and traditional practices may also influence the perpetration of violence.

Methods

In 2002, a qualitative study was conducted to explore the experiences of physically-assaulted victims of interpersonal violence at a local clinic in Leribe district of the Kingdom of Lesotho.

Results

Aggravating factors for interpersonal violence included jealousy, unemployment, availability of weapons, substance abuse and poor levels of education. Interpersonal violence was ameliorated by family interventions, reporting to the authorities, seeking protection from assailants and religious assistance. Most interpersonal violence occurred during the night and on weekends. The head and neck regions are the most common anatomical sites of injury.

Conclusion

Emotional and socio-cultural factors aggravate interpersonal violence in Lesotho, whilst family and religious interventions ameliorate it. Legislation addressing the protection of victims needs to be enacted, and community agencies dealing with interpersonal violence should be established. Studies which assess the requirements and the feasibility of intervention programs are also needed in the kingdom of Lesotho.

Gay Abuse Screening Protocol (GASP): screening for abuse in gay male relationships

Thirty-two male patients in gay relationships and eight family physicians were recruited from a family practice in order to determine comfort with an eight-question Gay Abuse Screening Protocol (GASP). The GASP was administered during a typical clinical encounter. After the encounter, physicians and patients each completed a 5-point Likert Scale questionnaire to assess their comfort levels with each of the 8 GASP questions (Likert Scale: 1 = not at all comfortable to 5 = very comfortable). The mean comfort score was high (Likert >4) for both patients (4.16 +/- 0.18) and physicians (4.71 +/- 0.18). However, mean comfort scores were significantly lower for abused patients (3.26 +/- 0.75) than nonabused patients (4.57 +/- 0.26). Patients were comfortable (Likert >3) with 76.2% of GASP items while physicians were comfortable with all GASP items.

Perfil clínico-epidemiológico de crianças e adolescentes do sexo feminino vítimas de violência atendidas em um Serviço de Apoio à Mulher, Recife, Pernambuco

OBJETIVOS: descrever o perfil clínico-epidemiológico de crianças e adolescentes um serviço determinando características biológicas e sócio-demográficas, tipos de violência, formas de intimidação, lesões, existência de gravidez e perfil dos agressores. MÉTODOS: estudo tipo corte transversal, de 170 prontuários das vítimas de violência de 0 a 19 anos atendidas no Serviço de Apoio à Mulher do Hospital Agamenom Magalhães em Recife, Pernambuco, de junho de 2001 a dezembro de 2002. RESULTADOS: a mediana de idade foi 16 anos. A maioria era parda e solteira. Cento e treze não concluíram o ensino fundamental e a renda familiar foi de até um salário mínimo (31,2%). A agressão sexual representou 64,7%, a principal região lesada foi a genital. Equimoses/hematomas corresponderam a 23,8% das lesões. Dezessete vítimas estavam grávidas à época da agressão. 31,7% dos agressores eram desconhecidos e utilizaram a força física (79,8%) como a principal forma de intimidação. Idade, renda e grau de escolaridade da maioria deles eram desconhecidos. Os agressores demonstravam sinais de consumo de álcool no momento da violência (34,2%). CONCLUSÕES: as vítimas eram pardas, de baixa escolaridade e baixo nível socioeconômico. Muitas sofreram lesões genitais. Seus agressores eram desconhecidos, utilizando força física para intimidação.

Domestic violence in the outpatient setting

Domestic abuse is a serious problem that may present directly or indirectly in the clinical setting. The astute physician may have the opportunity to directly intervene in this national dilemma. We present a patient who indirectly sought help through the medical setting, review the physician's responsibilities, and offer guidelines for management.