Domestic violence screening among primary health care workers in Kuwait

Background: Screening for violence against women provides an important opportunity for early detection and proper management of affected women. Primary health care workers can play an important role to implement screening measures for women. Multiple factors such as knowledge, attitude as well as barriers and enabling factors available for medical staff can affect these programs. Objectives: The aim of this study was to reveal the extent of screening for domestic violence among physicians and nurses in the primary health care unit, identify knowledge, attitude, and barriers toward violence screening, and reveal factors affecting screening. Subjects and methods: To achieve these objectives, an observational cross-sectional study was carried out in PHC centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A self-administrative questionnaire was used for data collection. Results: Less than two-thirds (62.5%) of the primary health care workers were aware about the topic while only about one-third (34.7%) regularly screened for violence among women. Of those regularly screening for violence, about two-thirds (66.1%) screened only less than 5% of women whom they examined, while 7.9% regularly screened more than 50% of their examinees. Physicians tended to screen for violence more than nurses as they constituted 51.2% of those screening compared with 26.4% of those not screening for violence, P 0.001. Those screening for violence had a significantly higher mean percent overall knowledge score (73.8± 9.5% compared with 70.9 ±11.2%, P =0.006) while they had a lower attitude score (65.5 ±16.5 compared with 70.1 ± 18.6%, P =0.015). Barriers related to the victim herself were the most common followed by those related to those related to women culture and administrative procedures. Conclusion: Primary health care workers admitted that they have low rates of screening for domestic violence against women. Physicians were more likely to screen for violence than nurses. Multiple barriers were revealed for screening including mainly those related to women whether their characteristics or culture in addition to administrative ones.