This statement summarizes the U Pre...

This statement summarizes the U Preventive Services Task Force (USPSTF) recommendations onward screening for family and intimate partner violence based forward the USPSTF's examination of evidence specific to family and intimate partner violence. It updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, inferior edition. (1) In 1996, the USPSTF place insufficient evidence to recommend for or against the use of specific instruments to discover domestic violence (a "C "recommendation, according to 1996 grade definitions). The task force now uses an explicit proces in which the balance of benefits and harms is determined exclusively at the quality and magnitude of the evidence. As a be derived current letter grades are based forward different criteria than those in 1996 common explanations of the ratings and of the nerve of overall evidence are given in Tables 1 and 2 respectively. The clean information on which this statement is based, including evidence tables and respects is available in the summary article (23) and in the systematic evidence review onward this topic, (4) available from one side the USPSTF Web site (http://www preventiveservices.ahrq.gov) and end the National Guideline Clearinghouse (http:// www.guideline.gov). The recommendation statement and summary article also are available from the Agency for Healthcare Research and Quality (AHRQ) Publications Clearinghouse in print from one side subscription to the Guide to Clinical Preventive Services, 3d ed: Periodic Updates. To order, contact the Clearinghouse at 1-800-358-9295 or e-mail ahrqpubs@ahrq.gov.

This recommendation first appeared in Ann Intern M 2004;140:382-6

Summary of Recommendation

* The USPSTF institute insufficient evidence to recommend for or against routine screening of parents or guardians for the physical abuse or failure of children, of women for intimate partner violence, or of older adults or their caregivers for earlier born abuse. I recommendation.

The USPSTF set up no direct evidence that screening for family and intimate partner violence leads to decreased disability or premature death. The USPSTF institute no existing studies that determine the accuracy of screening tool s for identifying family and intimate partner violence among children, women or older adults in the general population. The USPSTF fix fair to good evidence that interventions make less harm to children when child abuse or pay no heed to has been assessed (see Clinical Considerations). The USPSTF originate limited evidence as to whether interventions change into harm to women, and no studies that examined the effectiveness of interventions in older adults. No studies have directly addressed the harms of screening and interventions for family and intimate partner violence. As a rise the USPSTF could not determine the balance between the benefits and harms of screening for family and intimate partner violence among children, women or older adults.

Clinical Considerations

* The USPSTF did not review the evidence for the effectiveness of case-finding tools; however, all clinicians examining children and adults should be alert to physical and behavioral signs and symptoms associated with abuse or heedlessness Patients in whom abuse is suspected should receive peculiar documentation of the incident and physical findings (eg photographs, carcass maps);treatment for physical injuries; arrangements for skilled counseling at a mental health professional; and the telephone numbers of local crisis center shelters, and protective service agencies.

* Victims of family violence are primarily children, female spouses or intimate partners, and older adults. Numerous risk factors for family violence have been identified, although a certain may be confounded by socioeconomic factors. Factors associated with child abuse or contemn include low income status, soft maternal education, nonwhite race, large family size, young maternal age, single-parent household, parental psychiatric disturbances, and carriage of a stepfather. Factors associated with intimate partner violence include young age, cheap income status, pregnancy, mental health puzzles alcohol or substance use according to victims or perpetrators, separated or divorced status, and history of childhood sexual or physical abuse. Factors associated with the abuse of older adults include increasing age, nonwhite race, cheap income status, functional impairment, cognitive disability, substance use, poor emotional state, cheap self-esteem, cohabitation, and lack of social support.

* Several instruments to defence parents for child abuse have been studied, unless their ability to predict child abuse or slight is limited. Instruments to defence for intimate partner violence also have been expanded and although some have demonstrated serviceable internal consistency (e.g., the HITS instrument [Hurt Insulted, Threatened, s creamed at], the Partner Abuse Interview, and the Women 's Experience with Battering scale), none have been validated against measurable consequences Only a few screening instruments (i.e., the Caregiver Abuse disguise and the Hwalek-Sengstock Elder Abuse Screening Test) have been perform the operations indicated ined to identify potential older victims of abuse or their abusive caretakers. one as well as the other of these tools correlated well with previously validated instruments when administered in the community yet have not been tested in the primary care clinical setting. (4)