Description of IPV Screening
Importance
Screening for intimate partner violence (IPV) promotes disclosure and makes referral easier. When patients discuss a new close relationship at prenatal and early postpartum appointments, and when a patient appears with trauma or worrying symptoms, it is critical to employ IPV screening (City Health Information, 2017). The City Health Information (CHI) brochure from the NYC Dept of Health suggests screening using an efficient, standardized method such as the 4-question Abuse Assessment Screen (City Health Information, 2017).
Abuse Assessment Screen Questions
The first question is, “Have you ever experienced emotional or physical violence from a partner? If so, by whom?” The second one is, “Have you been beaten, slapped, kicked, or physically abused in the last year? If so, by whom?” Then, “Have you been compelled to have sex against your will in the last year? If so, by whom?”. Furthermore, it is necessary to ask if there is a fear of their partner. If a patient replies yes to one or more questions, conducting a safety and clinical evaluation and providing referrals for assistance is critical.
Comparison of IPV Screening Tools
HARK
HARK and WAST are the two IPV screening tools recommended by the USPSTF. Curry et al. (2018) acknowledge that HARK is an abbreviation for Humiliation, Afraid, Rape, and Kick, whereas WAST refers to the Woman Abuse Screening Tool. Consequently, HARK comprises four questions that measure emotional and physical IPV in the previous year. It is identical to the screening tool recommended by the CHI brochure from the NYC Department of Health.
WAST
On the contrary, WAST consists of eight measures assessing physical and emotional IPV. The USPSTF advises that clinicians assess women of reproductive age for IPV and offer or refer women who test positive to continuing support services (Curry et al., 2018). In the United States, IPV and abuse of older or vulnerable persons are frequent yet may go unnoticed (Curry et al., 2018). Additionally, long-term adverse health repercussions of elder abuse include mortality, an increased chance of nursing home placement, and poor psychological implications.
Preferred Tool
Although HARK and WAST evaluate a patient’s psychological and physical state, I would likely use HARK in my practice. It has fewer questions, making it easier to identify faster whether the patient experienced IPV. I would also like to employ the 4-question Abuse Assessment Screen because it has the same questions but allows people to talk and answer the open-ended questions, such as “If so, by whom?” This tool will provide more information and enable me to make better referrals to various help.
References
City Health Information. (2017). Intimate partner violence: Encouraging disclosure and referral in the primary care setting. The New York City Department of Health and Mental Hygiene, 36(2), 9-16. Web.
Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Grossman, D. C., Kemper, A. R., Kubik, M., Kurth, A., Landefeld, C. S., Mangione, C. M., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2018). Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults. US Preventive Services Task Force (USPSTF) final recommendation statement. JAMA, 320(16), 1678-1687. Web.