Two simple questions help you to screen your patient for abuse :
In general, how would you describe your relationship: a lot of tension, some or none?
Do you and your partner work out arguments with great difficulty, some or none?
If they answer "a lot of tension" or "great difficulty" please continue.
For the following questions, please answer often, sometimes or never:
Do arguments ever result in you feeling put down or bad about yourself?
Do arguments ever result in hitting, kicking, or pushing?
Do you ever feel frightened by what your partner says or does?
Has your partner ever abused you physically?
Has your partner ever abused you emotionally?
Has your partner ever abused you sexually?
If "often" or "sometimes" to any of the last three questions, need to assess risk:
Has the abuse occurred in the past 12 months?
Is the abuse still going on?
Do you still have contact with the abuser?
Do you feel unsafe now?
Are there children at risk of being abused or observing abuse?
If yes to any of the above:
Immediate referral to local abused women’s shelter, helpline, Children’s Aid Society, sexual assault centre
Discuss and assess health effects of woman abuse (physical, sexual, psychological, psychiatric)
Arrange referrals and follow-up
Address safety issues
Document details of the abuse