Learning Objective #1: Evaluate two levels of nursing intervention for intimate partner violence against women

Learning Objective #2: Consider strategies for application of tested nursing interventions to clinical practices

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This randomized, two arm, clinical trial reports the 12 and 24 month outcome data of the differential effectiveness of two levels of abuse treatment services: assessment and a wallet-size referral card (Standard care) or assessment, a wallet-size card and four 20-minute nurse case management sessions. The setting was primary care clinics. The participants were 360 abused women who assessed positive for physical or sexual abuse within the preceding 12 months. Outcome measures were number of threats of abuse, assault, danger risks for homicide, events of work harassment, safety behaviors adopted and use of community resources. Twenty-four months following treatment both groups of women reported significantly (p<.001) fewer threats of abuse (M=14.5; 95%CI 12.6,16.4), assaults (M=15.5, 95%CI 13.5,17.4), danger risks for homicide (M=2.6; 95%CI 2.1,3.0), and events of work harassment (M=2.7; 95%CI 2.3,3.1), but there were no significant differences between groups. Compared to baseline, both groups of women adopted significantly (p<.001) more safety behaviors by 24 months (M=2.0; 95%CI 1.6, 2.3); however, community resource use declined significantly (p<.001) for both groups (M=-0.2; 95%CI-0.4, -0.2). There were no significant differences between groups. Despite the recognition of intimate partner violence against women as a global health issue associated with significant morbidity and mortality, tested treatment strategies for the primary care setting are lacking. Women in this study experienced equal levels of abuse reduction and safety behavior adoption whether in the routine assessment and wallet-size card or assessment, wallet-size card and nurse case management program. Disclosure of abuse, such as what happens with abuse assessment, was associated with the same reduction in violence and increase in safety behaviors as a nurse case management intervention. Routine assessment for abuse, with the potential to interrupt and prevent reoccurrence of intimate partner violence and associated trauma, is indicated as standard care for women