McMaster University

McMaster University

Faculty of
Health Sciences

1 in 6 women at fracture clinics report domestic violence

Published: June 11, 2013
Mohit Bhandari
Mohit Bhandari, a professor and academic division head in the Division of Orthopedic Surgery (MacOrtho) who co-led the research for the PRAISE study
— photo by Stephen Uhraney

Large international study led by McMaster researchers

One in six women arriving at orthopedic fracture clinics have been victims of physical, emotional, or sexual violence at the hands of an intimate partner within the past year, and one in 50 arrive as a direct result of intimate partner violence (IPV), according to the largest multinational study of its kind to date, led by McMaster University researchers.

The report has been published on Online First by The Lancet.

"The unexpectedly high rate of IPV in orthopedics suggests that injury clinics are the ideal location for identification and support programs for victims of severe abuse who may be at increased risk of further injury and homicide," said Sheila Sprague, orthopedic research program manager at McMaster University. She co-led the research with Dr. Mohit Bhandari, a professor of orthopedic surgery at McMaster and an orthopedic surgeon for Hamilton Health Sciences.

"Almost three-quarters of the women in our study believed that health-care providers should ask all women about intimate partner violence, and about two-thirds agreed that orthopedic surgeons are particularly well placed to do this," Bhandari said. 

Worldwide, intimate partner violence is the leading cause of non-fatal injury to women. Musculoskeletal injuries are the second most common type of injury resulting from IPV and are often seen by orthopedic surgeons. Bhandari added, "Over one billion women around the world experience some form of gender-based violence each year. The frequency of physical injuries associated with the violence mandates that we, as orthopedic surgeons, work hard to identify and ensure the safety of women in our trauma clinics."

The research, called the PRAISE study, examined the yearly and lifetime prevalence of IPV among 2,945 adult women presenting to 12 fracture clinics across Canada, the U.S., the Netherlands, Denmark, and India. All the participants anonymously answered direct questions about abuse and completed two questionnaires (Woman Abuse Screening Tool and Partner Violence Screen) in private.

One in six women (16%) disclosed experiencing intimate partner violence in the past year, and one in three (34.6%) reported experiencing abuse at some point during their lives.

Also important, say the researchers, is that of the 47 women (2%) who attended their fracture clinic as a direct result of IPV, only 14% said they had ever been asked about abuse by a health-care professional.

According to the PRAISE investigators, "The U.S. Preventive Services Task Force has recently published a statement recommending that all clinicians screen women for IPV … Health-care professionals in injury clinics are well positioned to identify patients experiencing IPV, since they often develop long-term interactions with women during repeat clinic visits for follow-up of fractures and associated surgical procedures."

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