Oral health care professionals' attitudes and behaviors regarding domestic violence: The need for an effective and compassionate response

This study aimed to describe the knowledge, attitudes and clinical practice behaviors of oral health care professionals with regard to domestic violence. It also sought to determine whether there were any differences between dentists and hygienists with regard to these issues. This was the first national random survey of dentists and hygienists about domestic violence. The response rate was 54% for dentists and 61% for hygienists. Data were gathered from 1215 oral health care professionals using a written experimenter-designed survey based on literature review. Eight content areas related to domestic violence were surveyed: (a) screening and assessment, (b) deterrents to identification and referral, (c) response behaviors, (d) knowledge, of domestic violence, (e) reporting behaviors for domestic violence and child abuse, (f) domestic violence education, (g) personal experience with domestic violence, and (h) written practice protocols about domestic violence and child abuse. In addition, characteristics of the sample which included information on respondents' demographics, work setting, and patient population were gathered. Data were analyzed using the statistical software programs, SAS (SAS Institute, Inc.) and Statview. The majority (88%), of the sample never screened their patients for domestic violence at new patient visits or at periodic check-ups. 65% of the sample screened if presented with multiple sites of injury, or head, neck, or facial injury---56% of the sample had never identified a patient as a victim of domestic violence. Of those who have identified a patient as a victim: 54% made a note in the patient's chart, 48% expressed concern for the patient's safety, 30% gave shelter or victim services information, 10% facilitated arrangements for safety, and only 2% filed a police report. 28% elected not to intervene when they identified a patient as victim of domestic violence. Furthermore, 67% of respondents had no training in domestic violence in graduate school and 74% had not attended a CME course on domestic violence in the last 3 years. 85% do not have a written protocol for domestic violence, although those who did reported them helpful. About 1/3 of the sample had experienced abuse by a parent or guardian and 15% had experienced abuse by an intimate partner. The results of this study could lead to more effective educational training for oral health care professionals and policy changes within dentistry that would help identify victim of domestic violence earlier, and thus provide them with appropriate interventions in an effective and compassionate manner.