Domestic Violence Initiative Screening Questions
Joan Webster‚ Susan M. Stratigos‚ and Kerry M. Grimes. 1998
پرسش های غربالگری شناسایی خشونت خانگی
Health worker to explain the following in own words:
• In this health service‚ we are concerned about your health and safety‚ so we ask all women the same questions about violence at home;
• This is because violence is very common and we want to improve our response to families experiencing violence.
Health worker to ask the following questions of ALL female patients on their own:
1. Are you ever afraid of your partner? YES NO
2. In the last year‚ has your partner hit‚ kicked‚ punched or otherwise hurt you? YES NO
3. In the last year‚ has your partner put you down‚ humiliated you or tried to control what you can do? YES NO
4. In the last year‚ has your partner threatened to hurt you? YES NO
If domestic violence has been identified in any of the above questions‚ continue to questions 5 and 6.
5. Would you like help with any of this now? YES NO
6. Would you like us to send a copy of this form to your doctor? YES NO
DV Risk Status:
Domestic Violence not identified …
Domestic Violence identified‚ refused help …
Domestic Violence identified‚ help provided …
Provided With:
Contact phone numbers for DV ` …
Written information for DV …
Referral to hospital-based service …
Referral to community DV service …
Referral to GP …
Other: ____________________________
Screening Not Completed Due to:
Presence of partner …
Presence of family member/friend …
Absence of interpreter …
Woman refused to answer the questions …
Additional Comments:
شرح سایت روان سنجی: ایزار سنجش بالینی برای آگاهی از خشونت جسمی و عاطفی شریک زندگی است که مشاور بالینی تکمیل می کند.
چگونگی دستیابی
منبع و ماخذ
Queensland Government (1998). Domestic violence initiative screening tool‚ from http://www.health.qld.gov.au/violence/domestic/dvi/publications.asp)
Webster J‚ Stratigos SM‚ Grimes KM (2001). Women’s responses to screening for domestic violence in a health-care setting. Midwifery‚ 17‚ 289-294.
Webster J‚ Holt‚ V. (2004). Screening for partner violence: direct questioning or self-report? Obstetrics & Gynecology‚ 103‚ 299-303.