A clinical guideline for identifying intimate partner abuse in women'shealth services in Hong Kong

Abstract

Intimate partner abuse (IPA) is a global health problem affecting millions of women. It is linked with a wide range of negative health sequela including injuries, gastrointestinal disorders, chronic pain, depression, gynecological disorders, unwanted pregnancy, and sexually transmitted diseases (CDC, 2011). In Hong Kong and other Chinese societies, incidence of IPA is likely to be under-reported. This phenomenon is presumably due to the cultural norm in which shameful family issues tend not to be disclosed to members outside the family. However, in light of its related negative health consequences, early identification of IPA is important. In Hong Kong where majority of women attend primary health care settings for routine check-up, identification of IPA in this setting is feasible. The Abuse Assessment Screen (AAS), a well-established screening tool for IPA, suits this purpose. Previous studies in Hong Kong have shown that the Chinese version of AAS has satisfactory validity and high sensitivity for detecting IPA (Tiwari, Fong, Leung, Parker, & Ho, 2007). Therefore, this proposed guideline chose to use the Chinese version of AAS for IPA detection in women’s health services, with the purpose of minimizing under-reporting of IPA in Hong Kong.

The objectives of this study are (1) to conduct a systematic literature review on the IPA identification in health care settings; (2) to synthesize the outcomes from the identified literature for the translation of evidence-based practice; (3) to develop a clinical guideline for identifying IPA in women’s health services; (4) to assess the potential of implementing the proposed guideline; (5) to develop an implementation plan; and (6) to develop an evaluation plan for the proposed guideline.

A systematic literature search was performed for identifying relevant studies. Three electronic databases including PubMed, Ovid MEDLINE (OvidSP), and CINAHL Plus (EBSCOhost) were used. In total, six papers were yielded based on the inclusion criteria. Scottish Intercollegiate Guideline Network (SIGN) 2011 grading system was used to evaluate the level of evidence. The potential of implementing the proposed guideline was assessed based on the transferability of the findings, feasibility, and the cost-to-benefit ratio. An evidence-based guideline was developed based on the analysed research findings. Finally, an implementation plan and an evaluation plan for the proposed guideline were designed.

An evidence-based guideline for identifying IPA in women’s health services was developed in this translational research. It assists nurses, particularly in the women’s health services, to identify women survivors of IPA.