Intimate Partner Violence: Systematic Review and construction of a screening instrument for Primary Care

Abstract

Background: Intimate partner violence is a serious and highly prevalent public health issue, and a violation of human rights. Due to its short- and long-term negative effects on the victim's health, a General Practitioner can be the first professional contact for victims of intimate partner violence and provide the most help. There is currently no consensus about the correct screening practices for intimate partner violence. Some screening instruments have been translated to Portuguese. Our review seeks to evaluate the attitudes and beliefs of physicians and patients regarding screening, as well as understand its barriers and facilitators in a health care context. Finally, we develop a screening instrument for intimate partner violence in the Portuguese language. Methods: We carried out a systematic literature review, following the PRISMA guidelines. A total of 64 articles were subjected to categorical thematic analysis. Seventeen articles mentioned validated screening instruments, which were retrieved as a base for the construction of the Portuguese screening instrument. We then initiated a Delphi survey technique to gauge experts' opinions and suggestions for improving the pilot instrument. Results: From the analysis, four main categories were identified. Health professionals' beliefs and attitudes about screening, patients' beliefs about screening, perceived barriers and perceived facilitators to screening. In health professionals' beliefs and attitudes was found beliefs about the importance of screening and responsibility to screen, perceived level of preparation and comfort to screen and attitudes towards screening. The final version of the screening instrument is composed of forty-two items, divided into four categories: psychological, physical, sexual, and economic violence. Conclusions: Intimate partner violence screening is a crucial step to identify and help victims of abuse. There is still much debate about the correct screening practices, which serves as a barrier against quality care, as well as the lack of training for health professionals and the lack of available interventions for victims.