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One in six bone fracture patients linked to domestic violence

Nurses should note the possibility of patients presenting with bone fractures having suffered violence at the hands of a partner, research has suggested.

It found that one in six women attending orthopaedic fracture clinics had been victims of physical, emotional, or sexual violence inflicted by their partner during the previous 12 months.

One in 50 attends as a direct result of intimate partner violence (IPV), it found. Yet only 14% of this group were questioned about the cause of their injuries by a healthcare professional, according to the Canadian study published in The Lancet Online First.

The PRAISE (Prevalence of Abuse and Intimate Partner Violence Surgical Evaluation) research - the largest multinational study of its kind - was co-led by Sheila Sprague and Mohit Bhandari from McMaster University in Hamilton, Ontario.

Dr Sprague said: “The unexpectedly high rate of IPV in orthopaedics suggests that injury clinics are the ideal location for identification and support programmes for victims of severe abuse who may be at increased risk of further injury and homicide.

“Almost three-quarters of the women in our study believed that healthcare providers should ask all women about IPV, and about two-thirds agreed that orthopaedic surgeons are particularly well placed to do this.”

Globally, IPV 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 orthopaedic surgeons.

The PRAISE study examined the yearly and lifetime prevalence of IPV among 2,945 adult women presenting to 12 fracture clinics in Canada (six sites), the United States (two sites), the Netherlands (two sites), Denmark (one site) and India (three sites).

One in six (16%) disclosed experiencing IPV in the past year, while 34.6% reported experiencing abuse at some point during their lives.

Significantly, of the 47 women who attended their fracture clinic as a direct result of IPV, only 14% said they had ever been asked about abuse by a healthcare professional.

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Readers' comments (6)

  • Hang on a minute, 1 in 6 more like 1 in 50. Here's another statistic for you: 100% of those who have had an MI have moved there bowels within the seven days leading up to their MI!!

    What a load of rubbish.

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  • The overall response rate was 85% (2344 of 2759 patients provided informed consent). One in six women (455/2839, 16·0%, 95% CI 14·7—17·4%) disclosed a history of IPV within the past year, and one in three (882/2550, 34·6%, 32·8—36·5%) had experienced IPV in their lifetime. 49 women (1·7%, 1·3—2·2%) attended their clinic visit as a direct consequence of IPV, only seven of whom (14%) had ever been asked about IPV in a health-care setting.

    PRAISE is the largest prevalence study done so far in orthopaedics. Orthopaedic surgeons should be confident in the assumption that one in six women have a history of physical abuse, and that one in 50 injured women will present to the clinic as a direct result of IPV. The findings warrant serious consideration for fracture clinics to improve identification of, respond to, and provide referral services for, victims of IPV.

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  • I have enough to do without asking all these women (what about the men ?) if they have been the subject of domestic or other violence. .
    The police are willing and able to investigate allegations of abuse/violence.

    Ever heard of the "willing victim?"

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  • Anonymous | 12-Jun-2013 6:37 pm

    You are a real piece of work. I hope to God you are not a nurse. If you are, go and do a different job. You are not fit to be a nurse.

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  • Disgusting comment.

    Unsuitable or offensive?

  • Anonymous | 12-Jun-2013 6:37 pm

    Disgusting comment.

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