Domestic Abuse

How to Ask

Screening for domestic abuse can be

Try out a variety of options to see what is most comfortable for you.

At SHC, the standardized intake admission and ED abuse screening question is:

"Does a partner, or anyone at home, hurt, hit or threaten you?"

Written questions
Oral questions
Asking indirectly
Framing the question – this sets the stage for asking, so that the patient doesn’t feel embarrassed that you singled her out to ask
Asking directly
SAFE questions – a series of sequential questions

Written questions

Written questions are more efficient for your time, but, realizing that many patients with abuse issues will check “no”, please always add:

“I see that you have checked “no” about questions relating to feeling safe with your partner. Do you have any other questions about this issue? (No.) I just want you to know that if anything like this ever does come up, this is a safe place to talk about it and get help.”

Adding that last sentence above can have a dramatic, positive effect for your patient.

For written questions, you can use a combination of the questions under oral questions (the Agency for Healthcare Quality and Research suggests you ask at least three questions), or see Resources for a list of written screening instruments.

In addition, if you use written screening, always sign off on form, and/or document in your records the written screening results with a dictation comment or form checkbox, to insure that you do not overlook a “yes”.

Oral questions

Oral questions may be part of your routine history at new and annual visits, or may come up in response to a suspicious sign or symptom.  Here are several options in each category from which to choose.

Asking indirectly

Framing the question

Asking directly

SAFE Questions (oral, add sequentially as needed)

Stress/safety

  1. What stresses do you experience in your relationships?
  2. Do you feel safe in your relationship?

Afraid/abused

  1. People in relationships sometimes fight.  What happens when you and your partner disagree?
  2. Have there been situations in your relationship where you have felt afraid?
  3. Have you been physically hurt or threatened by your partner?
  4. Has your partner forced you to engage in sexual activities that you didn’t want?

Friends/family

  1. Are your friends and family aware of what is going on?
  2. Do you have a safe place to go in an emergency?

 

Stanford Medicine Resources:

Footer Links: