Domestic violence detection amid the COVID-19 pandemic: the value of the WHO questionnaire in emergency medicine

Abstract

Background: Gender-based violence affects 35-45% of women worldwide, mostly coming from domestic violence. A good screening procedure in clinical practice is useful, but WHO does not advise universal screening, recommending further research.

Aim: (i) To report the frequency of domestic violence cases among admissions to the Emergency Room of a major Italian Hospital in 2020, including during complete 'Lockdown' period; (ii) to document acute and chronic health effects of domestic violence and (iii) to asses usefulness of the WHO screening as a tool for uncovering cases which would otherwise remain hidden.

Design and methods: A database containing all the information recorded for each of 19 160 patients in the Emergency Room was constructed by a keyword search ('violence', 'assault', 'trauma') to filter the data and retrieve cases of violence in the period between 1 January and 2 June 2020. The self-administered questionnaire of the WHO Multi-country Study on Women's Health and Domestic Violence against Women was used in women referred to the emergency room for any cause, excluding trauma.

Results: A recent history of domestic violence was disclosed by 22.67%, after completing the WHO questionnaire. Of those not participating in the survey, diagnosis of domestic violence was only 0.6% (128/19 160).

Conclusion: Power of detection of domestic violence by the WHO questionnaire is very high, while the frequency of occurrence of these events in this population was considerable. Seemingly, it elicits the responsiveness to the topic of the volunteer interviewees. Its use should be firmly recommended, reasonably, while Covid-19 pandemic is affecting health, rights and response.