| Abstract/Notes |
Introduction:Family violence (including domestic/intimate partner violence, child abuse, and elder mistreatment) has been identified as a major public health concern. In addition to the associated physical and psychosocial co-morbidities, considerable evidence also suggests that such abuse heightens risk for health-detrimental behaviors, health care over-utilization, and subsequent re-victimization. Although the epidemiology of family violence has been difficult to establish due to patient under-reporting and the data indicating only a small minority of physicians (an estimated 15% or fewer) regularly screen for family violence, some prevalence estimates suggest, for example, that 44.2 per 1,000 women are victimized by intimate partner assault each year and that more than 1.5 million elders are mistreated annually, with a predicted upsurge in rates as “baby boomers” age. Hence, it is likely that the caseload of most health providers includes a substantial number of patients exposed to family maltreatment. Purpose:Considering the clinical and public health implications of family violence, the present paper will provide a conceptual overview on family violence, discuss the role of chiropractors in the detection of family violence, and present some emerging educational models for developing the key competencies to recognize these problems and move to action, with an emphasis on multidisciplinary collaboration in the biopsychosocial treatment of these multifaceted problems. This is particularly relevant given that the American Chiropractic Association supports legislation mandating the reporting of family violence. Methodology:A review of the empirical literature on family violence was conducted between the years 1995-2005 using PsycINFO and MEDLINE, supplemented by selected government reports, professional guidelines and other policy papers with a focus on issues relevant to epidemiology, training, and interdisciplinary collaboration. Discussion:Since family violence tends to escalate over time if there is no intervention, early detection is key. In spite of this fact, family violence has received very little attention in the chiropractic literature. Extrapolating from the broader research, several models of medical education have been proposed to address the critical need for assessment and early intervention that may inform chiropractic curriculum development around family violence. As chiropractors become more mainstream portal of entry providers and continue to strive to provide more primary care, there is a clear need to translate the didactics of family violence into the clinical setting to provide students the opportunity for mastering the basic competencies for managing these challenging problems and for inculcating skills commensurate with those of other primary care providers. Given the paucity of existing data on chiropractors knowledge and practices, more research is needed to provide a firm foundation to advance training and practice relevant to family violence and to evaluate their impact. This abstract is reproduced with the permission of the publisher. |
