Domestic Abuse

Question 1

What is domestic abuse?

Answer 1

Any form of physical, verbal, sexual, psychological or financial abuse
- which might amount to criminal conduct
- and takes place within the context of a relationship

Question 2

types of abuse

Answer 2

verbal
emotional
physical
sexual
financial

Question 3

Who is most at risk of domestic abuse?

Answer 3

• women
• women aged 16-24
• men aged 16-19
• long term illness or disability
• mental health problem
• pregnant women
• women who are separated

Question 4

Behavioural indications of abuse

Answer 4

low self esteem
victims may appear fearful, anxious or sad
alcohol
partner present may do all the talking
missed or frequent appointments

Question 5

Physical features of abuse

Answer 5

repeated injuries
bruises at different stages of healing
dental/maxilofacial injuries
unlikely explanations for injury
TMJ problems
facial bruising
bruising or strangle marks around neck

Question 6

barriers to screening for abuse

Answer 6

patient accompanies
lack of training
patient’s cultural norms
embarrassment
lack of knowledge about where to refer
lack o time

Question 7

What doe AVDR stand for

Answer 7

ask validate document refer

Question 8

AVDR - asking

Answer 8

ask about abuse
try and ask in as private a setting as possible
don’t ask in front of other family members
use non-judgemental language

Question 9

AVDR - validate

Answer 9

• even if patient denies should still do this
• may provide relief or comfort or help realise that they are in a serious situation

objective
- removes blame
- shows that you believe them and are taking it seriously
- e.g. ‘you do not deserve to be hurt” or ‘I am concerned about your safety/

Question 10

AVDR - document

Answer 10

be specific and detailed
use person’s own words as well as clinical notes
describe injuries in as much details as possible
take photographs if able

Question 11

AVDR - refer

Answer 11

signposting to appropriate services
- Scottish domestic abuse helpline
- do not attempt to deal with problem yourself

Question 12

what to give a patient that you suspect is a victim of domestic abuse

Answer 12

small card with contact details for domestic abuse organisations
or
- small gift with domestic abuse helpline number concealed on it

Question 13

Other ways to help pt who may be at risk of domestic abuse

Answer 13

put cards in toilets and waiting areas to let them know you are willing and able to talk about domestic abuse
allow patients to use phone in surgery to contact agencies if required
link with domestic abuse agencies and have their materials available
develop protocol to allow you to get patients on their own if partners are present and alert others of the issue - code words may be used
have staff wear asc badges