‘A stitch in time…may save nine’: A systematic synthesis of the evidence for domestic violence management and prevention in Emergency Care

Abstract

The aim of this policy brief is to provide an evidence-informed answer to the question: ‘What is the role and scope of pre-hospital emergency care providers to domestic violence (DV) intervention as a form of gender-based violence prevention?’ The answer is intended to determine the theoretical and clinical best practice to inform the emergency care community and policy development by critically appraising the evidence that considers the responsiveness of Emergency Medical Services to the health needs of DV victims. Evidence-informed Decision Making methods are employed. The evidence appraised was based on electronic searches
using the Cape Peninsula University of Technology database. Research and non-research publications were considered with publication dates mostly from 1999 to 2011. Upon screening 164 articles for content relevance, 53 were critically appraised against predetermined criteria for relevance of the evidence, robust nature of the evidence and presence of bias. A thematic/narrative analysis ensued in terms of strength of evidence and frequency of findings. Early recognition and intervention is seen as one of the most effective methods of DV prevention. This finding is nuanced if it is male caregivers doing so. There is an ethical obligation to implement a comprehensive health approach to manage domestic violence victims. The strong, majority findings are that educational intervention/s increases the health care provider’s understanding of DV and improves screening for DV. The research supports the development and use of screening tools/guidelines/ procedures for DV as they are found to improve DV intervention. The evidence supports an integrated effort of the health system in achieving its goal of DV prevention by promoting the participation of pre-hospital emergency care providers as critical stakeholders.

Key words: Domestic Violence (DV) management and prevention, Emergency Care Providers (ECP’s), Gender-based violence (GBV) prevention, Evidence-informed Decision Making (EiDM), Emergency Medical Service