Learning Objective 1: know about the debate in the literature regarding which instruments and methods are most effective in detecting abuse.
Learning Objective 2: learn that contradictory to what has previously been reported in the literature, there were no clear cut results found regarding which of the methods was more effective in revealing abuse.
Objectives: To evaluate, within the Icelandic health care setting, the effectiveness of two screening procedures, the a) “Women Abuse Screening Tool” (a self-report questionnaire), and b) the “Evaluation Interview Frame for Nurses and Midwives, Regarding Women Abuse, Screening and First Response”, in detecting women abuse within an emergency department (ED) and a high risk prenatal care clinic (HRPCC) in Reykjavik; and c) to evaluate the frequency of missing data based on the methods used.
Design: A descriptive, cross-sectional design was used in the study.
Settings: Data were collected at one time in 2006, over a period of 5 to 7 months, from women seeking health care services at an ED and pregnant women in their first trimester attending an HRPCC.
Methods: Two methods were used, a self-report instrument (the WAST questionnaire) and a face-to-face interview with a nurse or a midwife.
Results: A variety of prior and current abuse experience were disclosed by each method. The women disclosed, however, physical abuse more often in the face-to-face interview. The women at the ED disclosed more emotional and sexual abuse by an intimate partner by using the self-report instrument; but the women at the HRPCC disclosed the same ratio of emotional and sexual abuse regardless of the method used. In addition, the face-to-face interview had fewer missing data regarding disclosure of abuse. Contradictory to what has previously been reported in the literature, there were no clear cut results found regarding which of the methods was more effective in revealing abuse; rather, disclosure, for some of the women, was based on a combination of the two methods used and the type of abuse inquired about.
Conclusion: Implications might focus on using different methods within different clinical settings, e.g., face-to-face interviews at an ED, but questionnaire(s) at a High Risk Prenatal Clinic; or on using mixed methods approach within the same clinical setting. Such decision should however be based on the purpose of screening for women abuse and on how and in what way clinicians and researchers are going to intervene with the women.