Abstract
BackgroundPrimary care physicians underestimate the prevalence of domestic violence and community violence. Victims are therefore at risk of further episodes of violence, with psychological and physical consequences. We used an interview to assess the prevalence of domestic and community violence among Swiss natives and foreigners. In a follow-up study, we evaluated the consequences of the interview for the positive patients.MethodsWe evaluated the prevalence of violence by use of a questionnaire in an interview, in an academic general internal medicine clinic in Switzerland. In a follow-up, we evaluated the consequences of the interview for positive patients. The participants were 38 residents and 446 consecutive patients. Questionnaires were presented in the principal language spoken by our patients. They addressed sociodemographics, present and past violence, the security or lack of security felt by victims of violence, and the patients' own violence. Between 3 and 6 months after the first interview, we did a follow-up of all patients who had reported domestic violence in the last year.ResultsOf the 366 patients included in the study, 36 (9.8%) reported being victims of physical violence during the last year (physicians identified only 4 patients out of the 36), and 34/366 (9.3%) reported being victims of psychological violence. Domestic violence was responsible for 67.3% of the cases, and community violence for 21.8%. In 10.9% of the cases, both forms of violence were found.Of 29 patients who reported being victims of domestic violence, 22 were found in the follow-up. The frequency of violence had diminished (4/22) or the violence had ceased (17/22).ConclusionThe prevalence of violence is high; domestic violence is more frequent than community violence. There was no statistically significant difference between the Swiss and foreign patients' responses related to the rates of violence. Patients in a currently violent relationship stated that participating in the study helped them and that the violence decreased or ceased a few months later.
Highlights
Primary care physicians underestimate the prevalence of domestic violence and community violence
The prevalence of violence is high; domestic violence is more frequent than community violence
There was no statistically significant difference between the Swiss and foreign patients' responses related to the rates of violence
Summary
Primary care physicians underestimate the prevalence of domestic violence and community violence. Violence is defined by the World Health Organization (WHO) as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation." Violence can be divided into three broad categories, which are selfdirected violence, interpersonal violence, and collective violence. It includes violence that is perpetrated by intimate partners and other family members, and that is manifested through physical abuse, sexual abuse, psychological abuse, economic abuse, and acts of omission [2]. According to the WHO, an estimated 1.6 million people from around the world died as a result of violence (homicide, suicide, and war-related violence), and 520,000 were killed as a result of interpersonal violence, in 2000 This is the "tip of the iceberg," as it is impossible to estimate non-fatal violence precisely [1]. In a survey of the health of the Swiss people, 10% of men and 8% of women reported that they had suffered at least one form of violence (verbal, physical or sexual, or crime against propriety) in the last 12 months [5]
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