Domestic Violence Screening Research Articles

Investigating the impact of Cognitive Processing Therapy (CPT) on Post-Traumatic Stress Disorder (PTSD), depression, and anxiety symptoms in female victims of domestic violence.

This study aimed to investigate the effects of CPT on PTSD, depression, and anxiety symptoms in female victims of domestic violence. A two-arm randomized clinical trial was conducted in Bandar-Abbas involving 62 female victims of domestic violence referred from private gynecology and obstetrics clinics. Initial screening for domestic violence was based on the World Health Organization violence questionnaire. Participants were randomly assigned to either a control group (n=32) or an intervention group (n=28) for a study duration of six months in 2022. Twelve group CPT sessions were conducted. The domestic violence questionnaire, Beck's Depression Inventory, Beck's Anxiety Inventory, and the Impact of Event Scale-Revised were completed in three time points: pre-test, post-test, and follow-up. There was a statistically significant difference in the mean scores of depression, PTSD, and domestic violence (P less than .001) between the two groups; however, no significant difference was found in anxiety scores (P greater than .050). CPT is recommended for female victims of domestic violence to reduce symptoms of depression, PTSD, and domestic violence.

Is domestic violence during COVID-19 in lactating women related to infantile colic? An important question

BackgroundPsychosocial factors such as maternal stress in lactating women were shown to be related to an increased risk of infantile colic because the infants can be affected through breast milk. Therefore, domestic violence against lactating mothers can be effective on the infants’ health. It is also demonstrated that domestic violence against women has increased following the COVID-19 pandemic and quarantine. Therefore, this study aims to assess the relationship between domestic violence against breastfeeding women during COVID-19 and the incidence of infantile colic.MethodsThis was a case-control study that was conducted on 356 lactating mothers who attended Bentolhoda Hospital in Bojnoord-Iran from November 2021 to August 2022. The participants were exclusively breastfeeding mothers who were under 6 months infants. Mothers with and without infantile colic infants were considered the case and control groups, respectively. Two questionnaires were used for data collection including a demographic questionnaire, and a questionnaire to assess domestic violence against women during the quarantine period of Corona pandemic. The data was analyzed using SPSS-V22 and Pearson Spearman correlation and linear regression tests.ResultsThe results showed that women in the case group had a significantly higher score for “sexual violence and restraint” than women in the control group [0.59 ± 0.34 versus 0.62 ± 0.25 (Mean ± SD), respectively] (P < 0.05). The chance of infantile colic was higher among the infants of mothers who experienced domestic violence, but it was not statistically significant (OR = 1.236, P = 0.573). Significant relationships were found between the infantile colic and the history of abortion (OR = 1.430, P = 0.028) and cesarean section (OR = 1.723, P = 0.044).ConclusionDomestic violence during pregnancy can potentially increase infant colic through breast milk. Although our findings need more investigation, it can be recommended to plan the direction of screening for domestic violence and providing the necessary care and counseling to the parents in perinatal care services to prevent infantile colic and improve the infant’s health.

Help-seeking behavior of male victims of intimate partner violence in Japan.

Intimate partner violence (IPV) is becoming a serious public health issue worldwide. This study sought to analyze factors affecting the help-seeking behavior of male victims of IPV using a web survey. Male IPV victims living in Japan were recruited to participate in a web-based questionnaire survey conducted on February 25 and 26, 2021. A total of 1466 men were divided into two groups: Group 1 (43 men) consisted of victims who sought help and Group 2 consisted of victims (1423 men) who had not sought help. The Domestic Violence Screening Inventory, a 20-item questionnaire regarding IPV exposure, and the Patient Health Questionnaire-9 were used, along with the questions regarding help-seeking behaviors for Group 1. Of the 43 victims, 28 victims (65.1%) used exclusively informal supports, eight victims (18.6%) used exclusively formal supports, and seven victims (16.3%) used both. Logistic regression analyses revealed that only physical violence was significantly associated with help-seeking behaviors among types of abuse/violence (odds ratio [OR] = 4.51, confidence interval [CI] = 1.95-10.50, P < .001). Of past experiences, "foregoing divorce to avoid adverse childhood experiences in their offspring" (OR = 3.14, CI = 1.45-6.82, P = .003) was the most significantly associated with help-seeking behaviors. In Japan, male IPV victims tend to seek help following physical violence, but males are less are likely to seek help for nonphysical victimization, highlighting the need for targeted support for victims of nonphysical abuse. To provide comprehensive aid to male IPV victims, consultation centers designed for men will be needed.

Domestic and Family Violence Screening and Response: A Prospective, Cross-Sectional, Mixed Methods Survey in Private Mental Health Clients.

Most domestic and family violence (DFV) research has focused on establishing prevalence and screening rates in public health and community samples. This study sought to address a gap in the literature by evaluating DFV screening and response practices in a private mental healthcare inpatient service and determining if clients of the service had unmet DFV needs. A prospective, convenience sample, mixed methods, cross-sectional survey of adult inpatient mental health consumers was employed. Sixty-two participants completed the Royal Melbourne Hospital Patient Family Violence Survey. Quantitative Likert-type and categorical responses were collated and analysed descriptively (count and percentage). Free-text responses were analysed using qualitative description within a content analysis framework. Sixty-five percent of participants had been screened for at least one DFV issue, on at least one occasion, with 35% not being screened, to their recall. Twenty-three percent reported disclosing DFV concerns, 82% felt very supported by the clinician's response to their disclosure, and 86% were provided with information they found helpful. Unmet needs were identified in 13% of participants, who had wanted to disclose DFV concerns but not feel comfortable to do so. No unscreened respondents disclosed DFV concerns, highlighting the need to uphold best practice guidelines for direct enquiry. Most disclosing clients were positive about the support they received. Indicated areas for improvement were screening rates, active follow-up, increasing psychology support levels and safety planning.

Integrating Trauma-Informed Clinical Interviewing Skills in Medical Education for Screening Domestic Violence and Abuse.

A pre-post-training workshop was conducted among 22 postgraduate trainees of the Psychiatry and Emergency Department of a public sector hospital in Karachi. The workshop aimed to build the capacity of postgraduate trainees in trauma management by providing training on screening, clinical interviewing skills, and Psychological first aid to those exposed to domestic violence (DV). The effectiveness of each training module was evaluated by conducting a brief assessment before and after each module and scores were compared using the Wilcoxon signed-rank test. The post-test showed significant improvement in participants' knowledge on screening of domestic violence and trauma symptoms (p = 0.026) and psychological first aid (p <0.001). Postgraduate training programmes need to integrate trauma screening and management education, to prepare healthcare professionals to deal with sensitive clinical presentations at their work settings. Key Words: Postgraduate trainees, Trauma, Domestic violence, Medical education, Workshop.

Experiences of Domestic Violence in Adult Patients with Brain Injury: A Select Overview of Screening, Reporting, and Next Steps.

This select overview examines the important intersection of adult domestic violence, including intimate partner violence and elder abuse, with brain injury. Despite the high prevalence of domestic violence amongst brain injury patients, there is a notable gap in screening and management training for providers. To provide optimal patient care, brain injury medicine clinicians must screen, recognize, and treat patients who have experienced domestic violence. This select overview highlights barriers to screening, validated screening tools from other medical disciplines, and management considerations for the brain injury clinician. A suggested protocol for domestic violence screening and management, as well as recommended resources for providers and patients, is summarized.

Incorporating Trauma-Informed and Culturally Competent Care Within Domestic Violence Screening Training for Medical Students

Incorporating Trauma-Informed and Culturally Competent Care Within Domestic Violence Screening Training for Medical Students

Intimate partner violence, social support and depression in pregnant women in Nigeria

Intimate Partner Violence (IPV) is a risk factor for depression both during and after pregnancy in many communities. The prevalence of domestic violence is common in Kano, Nigeria. Poor social support has been associated with depression. The specific aim of this section was to assess IPV, social support, and association with depression in a group of rural and urban pregnant women. The study was part of a larger study that assessed antenatal women at urban and rural sites using a sociodemographic questionnaire, a Hits Domestic Violence Screening Instrument, a Multidimensional Scale of Perceived Social Support, a MINI International Neuropsychiatric Interview -7, and other instruments. The prevalence of antenatal depression was 23.7%. Fifty percent of the depressed women, as compared to only 7% of nondepressed, had been victims of IPV. IPV was a predictor of antenatal depression in the whole sample and the urban women. Regardless of how long ago IPV occurred, it still served as a significant factor in causing antenatal depression. IPV is a significant predictor of antenatal depression.

The association of domestic violence during pregnancy with maternal psychological well-being in the early postpartum period: A sample from women with low socioeconomic status in Eastern Turkey

AimTo examine the association of women's exposure to domestic violence during pregnancy with postpartum maternal psychological well-being (postpartum depression and anxiety) in the early postpartum period. MethodsThe sample of this descriptive correlational research study comprised 358 women. Data were collected using the Personal Information Form, the Domestic Violence Screening Tool, the Edinburgh Postnatal Depression Scale, and the Postpartum Specific Anxiety Scale. The one-way multivariate analysis of variance, and a multivariate linear regression analysis was performed to analysis of data. ResultsThe mean scores of the HITS, the EPDS, and the PSAS were 6.00±16.00, 7.47±5.57, and 72.02±18.63 respectively. Considering the cut-off values of the scales, the women were found to be at risk for exposure to domestic violence (20.1%), postpartum depression (24%), and postpartum anxiety (11.2%). Education level and having social security was significantly associated with women's HITS and PSAS score.Women with high mean domestic violence scores had high mean postpartum depression and postpartum anxiety scores. Women's mean domestic violence and postpartum anxiety scores were significantly and positively associated with their mean postpartum depression scores (p < 0.001). ConclusionThe results of this study revealed that women were frequently exposed to DV during pregnancy, education level and social security were important predictors of exposure to DV, and that DV associated with postpartum depression and postpartum anxiety. Exposure to DV and postpartum anxiety increased the risk of postpartum depression. It is recommended to integrate screening, guidance, and supportive counseling practices into routine antenatal care to improve the mental health of pregnant women at risk.

Prevalence of intimate partner violence in pregnant women during the COVID-19 epidemic in Qazvin-Iran 2021

IntroductionIntimate partner violence (IPV) in pregnant women is considered one of the most important types of violence, which can include physical, psychological abuse and sexual violence. During the lockdown due to COVID-19, the home is at risk of becoming a very dangerous place for victims of domestic violence. We aimed to determine the prevalence of IPV and associated factors in pregnant women in Qazvin, Iran.MethodsThis cross-sectional study was conducted on 450 pregnant mothers who were referred to the Kowsar Hospital Prenatal Clinic in Qazvin in 2021. Participants were assessed using a questionnaire consisting of four parts (demographic data, Abuse Assessment Screen (AAS) for domestic violence, The Revised Conflict Tactics Scale (CTS2) for IPV. Data were collected and analysis was performed via SPSS software version 22 using a non-parametric test; Mann–Whitney and × 2 tests.ResultsThe overall prevalence of IPV was higher in pregnant women than their husbands in Qazvin. The most common form of IPV was psychological aggression (24.8%), followed by scale of injury (8.2%), physical (3.3%) and sexual (4.2%) violence. In addition, analysis of the AAS questionnaire shows that psychological violence is the most common form of domestic violence among pregnant women.ConclusionIn this study, IPV in pregnant women has increased slightly compared to studies conducted in the years leading up to the COVID-19. Risk of IPV was not related to previous COVID-19 infection. Collaborative efforts between various stakeholders and policy actions must be taken to ensure the safety and protection of pregnant women during this challenging time.

Low uptake of gynecological consultation following domestic or sexual violence: A case-control study during pregnancy follow-up

ObjectiveThe aim of this study was to examine the association between exposure to domestic and sexual violence and low uptake of gynecological consultation. Study designBetween October 2021 and October 2022, a case-control studywas conducted in mother andchild centers and sexual health centers in the Paris, France area. The case group included pregnant women who did not have a scheduled gynecological consultation in the past two years. The control group included pregnant women who had a scheduled gynecological consultation in the past two years. Pregnant women were interviewed using a standardized questionnaire about a history of domestic and sexual violence, the date of their last gynecological consultation and the gynecological health. ResultsA total of 405 pregnant women were included in the case group (n = 129) or in the control group (n = 276). After adjustment for age, couple, social security, supplementary health insurance, dyspareunia, abnormal vaginal discharge, dysmenorrhea, regular pelvic pain, mastodynia, vulvodynia and history of difficult delivery, a history of intimate partner violence was associated with the absence of a gynecological consultation in the past two years (OR 2.13; CI95% 1.21–3.73, p = 0.008). A history of sexual violence, regardless of age, was associated with the absence a gynecological consultation in the past two years (OR 1.92; CI95% 1.05–3.49, p = 0.03). The absence of a gynecological consultation was associated with dyspareunia and domestic or sexual violence (p < 0.0001 and p < 0.0001, respectively). ConclusionsThis study highlighted the association between domestic and sexual violence and the absence of gynecological consultations in the past two years. It underlines the importance of screening for domestic and sexual violence during gynecological consultations and its impacts on mental health, in particular psychotraumatic symptoms, and on gynecological health, in particular dyspareunia.

Interprofessional Education for Domestic Violence Safety Planning in Nursing and Social Work: A Scoping Review

ABSTRACT Nurses and social workers play pivotal roles in identifying and addressing domestic violence (DV) within healthcare settings, emphasizing the importance of their collaborative efforts. This scoping review investigates the current state of simulation education aimed at equipping nursing and social work students to screen, assess, and intervene in DV cases. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, our automated database search identifies pertinent evidence. Results categorize articles based on 1) instructional methods and student assessment, 2) challenges faced in DV-focused Interprofessional Education (IPE), and 3) benefits derived from such education. Conclusions underscore the imperative for enhanced IPE opportunities, emphasizing the interdisciplinary collaboration required for effective DV screening, assessment, and management in healthcare settings.

Inside Indonesia’s Religious Courts: An Argument for Domestic and Family Violence Screening and Exemption from Compulsory Mediation

Abstract In Indonesia, Islamic norms have been codified into State family law and divorce petitions are handled by State ‘Religious Courts’ (Pengadilan Agama). Formal, court-annexed mediation at the Religious Courts exists alongside customary (adat) mediation at the community level. In cases involving domestic and family violence, victims are socially expected to mediate at the community level before proceeding to the Religious Courts for formal determination of divorce petitions. At the Religious Courts, mediation is currently compulsory for all divorce petitions, even where there is proof or allegations of domestic and family violence. We argue that mediation should not be compulsory for victims of domestic and family violence who seek divorce via State family law avenues. In practice, victims bringing divorce petitions to the courts have generally already participated in mediation at the community level and therefore, further mediation has little—if any—utility. Further, there are well-documented risks for victims of domestic and family violence in mediation contexts. We draw on the comparative models of family violence screening from Australia and Canada to argue that similar screening processes should be introduced into Indonesia’s Religious Courts in order to exempt such cases of violence from compulsory mediation.

Intimate partner violence; breaking the silence on male victims in Nigeria

Globally, men have always been seen as perpetrators of aggression in romantic relationship which constitute intimate partner violence (IPV). In Nigeria, they are mostly considered as the villains due to the patriarchal nature of the society. However, there have many cases of violence by intimate partners where men were the victims. Very few of such cases were reported either to the hospital or to the police due to many reasons ranging from sociocultural, ethnic, economic and religious values among others. In a patriarchal society like Nigeria, men experience various form of violence which could be physical, psychological, sexual and socioeconomic from intimate partners. Therefore, this article attempts to review the reported incidence of male victims of IPV in Nigeria and the peculiarities involved while providing recommendations. Some of the factors identified for the low incidence report includes; lack of routine screening for domestic violence in health facilities, the fact that psychological violence is not considered as violence in some Nigerian society, shame about disclosing family violence, poor socioeconomic status and many more. Additionally, a major predictor of female-perpetrated IPV was childhood exposure to violence. This paper recommends that several actions which would improve the report of IPV against men while ameliorating IPV in Nigeria may involve: raising public awareness, legal protection, increasing health care worker sensitivity, provision of support services, research and proper data collection among others.

EFFECTIVNESS OF DIVORCEMEDIATION IN INDONESIA: COMPARATIVE LEGAL STUDY OF UNITED STATES

Victims of Domestic Violence (KDRT) are increasing every year, which is one of the causes of divorce. CATAHU Komnas Perempuan 2022 reported that as many as 4,779 cases of divorce were due to domestic violence. The divorce process is preceded by a mediation stage as a dispute resolution by mediators at the Religious Courts. Mediators who handle divorce cases must be thorough and have a strategy for identifying and dealing with domestic violence. Domestic violence screening (KDRT screening) needs to be done so that the identification of cases of domestic violence can be explained specifically. One of the countries that have implemented screening is the United States, which considers it an appropriate and effective method. Comparison of the legal system becomes an analytical knife regarding the legal process of mediation between Indonesia and the United States. Domestic violence screening conducted in divorce mediation can identify violence that occurs. If there is an act of violence, the mediator can use a different approach during mediation. Mediation should be able to help both parties reach an agreement that is fair and profitable for both while taking into account the rights and obligations of the parties.

Barriers Faced by Australian and New Zealand Women When Sharing Experiences of Family Violence with Primary Healthcare Providers: A Scoping Review.

Despite the Australian Government's attempts to reduce domestic violence (DV) incidences, impediments within the social and health systems and current interventions designed to identify DV victims may be contributing to female victims' reluctance to disclose DV experiences to their primary healthcare providers. This scoping review aimed to provide the state of evidence regarding reluctance to disclose DV incidents, symptoms and comorbidities that patients present to healthcare providers, current detection systems and interventions in clinical settings, and recommendations to generate more effective responses to DV. Findings revealed that female victims are reluctant to disclose DV because they do not trust or believe that general practitioners can help them to solve their issues, and they do not acknowledge that they are in an abusive relationship, and are unaware that they are in one, or have been victims of DV. The most common symptoms and comorbidities victims present with are sleep difficulties, substance use and anxiety. Not all GPs are equipped with knowledge about comorbidities signalling cases of DV. These DV screening programs are the most prominent intervention types within Australian primary health services and are currently not sufficiently nuanced nor sensitive to screen with accuracy. Finally, this scoping review provides formative evidence that in order for more accurate and reliable data regarding disclosure in healthcare settings to be collected, gender power imbalances in the health workforce should be redressed, and advocacy of gender equality and the change of social structures in both Australia and New Zealand remain the focus for reducing DV in these countries.

Male intimate partner violence (IPV) victims in Japan: Associations of types of harm, sociodemographic characteristics, and depression trait.

The purpose of this study was to examine factors affecting depression trait among male intimate partner violence (IPV) victims in Japan utilizing a multiple linear regression analysis. A web-based questionnaire survey was conducted. Male IPV victims living in Japan were recruited to answer the questionnaire on the website on February 25-26, 2021. A total of 16,414 subjects were enrolled, of whom 1466 respondents were included in the study. Other than IPV exposure, information about sociodemographic characteristics, past traumatic experiences and psychiatric history was collected. The Domestic Violence Screening Inventory (DVSI), a 20-item questionnaire regarding IPV exposure, and the Patient Health Questionnaire-9 (PHQ-9) were used to determine the intensity and the type of IPV harm and to screen for depression, respectively. The victims were more frequently subject to psychological abuse than to physical violence. Based on PHQ-9 scores, 10.7% of respondents exhibited moderate to severe depression. In the DVSI score, 79.2% of respondents required "observation and support." The lowest level of academic attainment (junior high school), positive psychiatric history, foregoing divorce to avoid adverse childhood experiences of their offspring, childhood exposure to domestic violence, younger age, having no children, and experience of school bullying were shown to be significantly associated with depression trait. Male IPV harm has a multilayered complexity. The sociodemographic characteristics and experiences of victims' own have a greater impact on depression trait than direct violent harm, suggesting that the violence-focused support might be inadequate for male victims. Comprehensive supports are urgently needed.

"If Not Me, Then Who?": Exploring the Challenges Experienced by Front-Line Clinicians Screening for, and Communicating About, Domestic Violence in the Emergency Department.

Screening for domestic violence in healthcare settings increases detection. The emergency department (ED) is one setting where victims frequently attend with injuries and illnesses sustained from violence. However, screening rates remain suboptimal. There is little research about how formal screening occurs, or how less structured interactions are negotiated within the ED context. This article explores this important, but non-mandatory procedure within the context of clinician-patient interactions in Australia. A descriptive qualitative study was undertaken with 21 clinicians across seven EDs in Australia. Thematic analysis was undertaken by two researchers. Results indicate a lack of confidence around DV screening, and tensions in clinicians initiating conversation while managing their own emotional stressors. No participants expressed knowledge of formal screening processes in their workplaces. Successful DV screening programs must provide clinicians with the tools to minimize perceived discomfort in initiating and sustaining conversations while accepting patient preferences regarding disclosure.

Socio-Economic Characteristics and Risk Factors Affecting Domestic Violence in Montenegro: A Case-Control Study.

Domestic violence is defined as the combined pattern of physical, psychological, economic and/or sexual violence against a family member. Intimate partner violence is the most common form. We aimed to present the basic characteristics of the Montenegrin families and family members affected by domestic violence, with the intent to inform the global mosaic of differences related to cultural specificities. A cross-sectional study was performed using 323 cases judicially processed and officially judged according to Criminal Act from 2015-2017 in Montenegro. Socioeconomic characteristic were investigated followed by analysis of many variables. Demographic characteristics, socio-economic status, and other characteristics of the perpetrators and the victims, as well as characteristics of violent act with posible risk factors, are presented. The results of case-control analyisis of intimate-partner relationships are given, too. A typical example of domestic violence in Montenegro shows an intimate couple with a violent male and a victimized female partner, living in a rented residence in the suburbs, with both partners in the fourth decade of their lives. The most frequent income level was poor, with half of the batterers and nearly three quarters of the victims unsatisfied with their marriage. The increased presence of such factors (both modifiable and unmodifiable) in the partiarchical families suffering from domestic violence should spark interest in public health and government authorities regarding domestic violence screening adapted for patriarchical societies.

Domestic Abuse Screening: Normalizing Assessment at Triage through Simulations

Background: Research suggests those residing in rural and remote locations across the province are more vulnerable to domestic violence (DV), with rates of DV and domestic homicide being three times higher than in urban areas (Canadian Domestic Homicide Prevention Initiative, 2019). Alberta has the third highest rate of police reported DV cases across Canada (Statistics Canada, 2019). Complex social determinants leading to this increase include geographic and social isolation, economic barriers, traditional social values, barriers to services, public visibility and the prevalence and normalization of firearms (Canadian Domestic Homicide Prevention Initiative, 2019). This simulation helps participants to recognize signs of possible domestic violence using screening tool at triage, understand and identify local processes available for domestic abuse and what resources their care area may have for victims. Methods: To support and empower frontline healthcare professionals to recognize and respond to domestic violence within the healthcare setting, a partnership between South Zone (SZ) educators, the AHS (Alberta Health Services) eSIM team and the Provincial Domestic Abuse Response Team (DART) was created. Through a shared vision of empowering frontline healthcare staff, a unique Domestic Violence Screening Scenario was developed. Utilizing a flipped classroom approach, participants are provided didactic education prior to participating in the SBE, followed by a debrief using an adapted PEARLS framework approach. The approach provides a psychologically safe, judgement free environment to engage in critical reflexivity and discussion of the complex social determinants that place those residing in rural and remote areas at additional risk of experiencing DV (Canadian Domestic Homicide Prevention Initiative, 2019). Additionally, participants are given the opportunity to practice utilization of the DV universal screening tool and develop understanding of the importance of routine screening within a healthcare setting. Currently this education scenario is provided during the annual Rural Skills Days at each of our south zone sites. Evaluation Methods: The SZ educators, AHS eSIMs Provincial Scientific team and DART developed several evaluation tools to capture data regarding the impact and applicability of the SBE Domestic Violence Screening Scenario, both on participants and patients seeking support for domestic violence in the emergency department setting. Data collection activities to measure the outcomes and impact of the SBE include: A pre- and post-SBE quantitative survey, which includes effective self-reported measures on: (1) attitudes of personal bias (2) communication strategies and (3) awareness of organizational resources. Participants will be contacted 3 and 6 months after the session for the following: Completion of the same evaluation survey (pre- and post-SBE) to capture data regarding the applicability of SBE learning to their clinical role in the emergency department. Participation in semi-structured interviews to collect rich data concerning applicability of the SBE, longitudinal impact on clinical practice and participants success in integrating domestic violence screening. Results: As a result of the SBE pre-qualitative evaluation surveys and post simulation debriefing sessions, participants are more likely to admit discomfort in caring for patients who are experiencing DV, due to lack of knowledge and training in this area. Through the pre-session evaluation survey and the post-session debrief period, many participants shared discomfort in caring for patients experiencing DV. Furthermore, due to a lack of knowledge and training in this area of practice, many professionals disclosed avoiding asking patients about DV even when injuries point to violence in the home. Advice and Lessons Learned: We have found Rural Emergency Department nurses are not comfortable with asking the domestic violence screening question due to discomfort with the subject matter, dual relationships with patients living in the same small communities, and lack of experience when building rapport with patients who are experiencing DV. We recommend the following considerations when implimenting a similar educational opportunity to support healthcare professionals to practice DV screening and to build skills needed to support patients experiencing DV: Utilization of a scaffold approach. Collaboration with content experts such as DART team members is imperative when running simulations to standardize how DV patients presenting to the ED (Emergency Department) are cared for provincially. It is important to use an inter-professional approach to strengthen the ED team to assist in role clarity when caring for patients experiencing DV.