Development and validation of a brief screening tool for detecting intimate partner violence in Hong Kong emergency departments

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Development and validation of a brief screening tool for detecting intimate partner violence in Hong Kong emergency departments

 

Author: Chan, Chi-chung
Title: Development and validation of a brief screening tool for detecting intimate partner violence in Hong Kong emergency departments
Degree: D.H.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Family violence -- China -- Hong Kong -- Prevention.
Emergency medicine -- China -- Hong Kong.
Women -- China -- Hong Kong -- Health risk assessment.
Department: Dept. of Applied Social Sciences
Pages: xv, 210 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2321673
URI: http://theses.lib.polyu.edu.hk/handle/200/5322
Abstract: Intimate partner violence (IPV) is a common problem globally, with grave effects on women's health and safety. The consequences of IPV are serious because victims and their children are often trapped in a cycle of violence from which they cannot escape. The World Health Organisation states that 40-70% of female murder victims are killed by their own spouses. It also urges healthcare providers to maximise their efforts to break that cycle of violence against women because of the profound medical and psychosocial consequences and the enormous healthcare, family and societal costs. Many women attending emergency departments (EDs) have experienced different degrees of IPV. However, no validated screening tool or protocol has been developed in the local setting for the purpose of screening for IPV in EDs. It is believed that an effective screening tool for IPV can generally increase the rate of identification of potential victims and allow healthcare providers to make a contribution to the prevention of family violence in Hong Kong. The purpose of this study is to develop and validate a brief screening instrument, E-HITS, for detecting female IPV in EDs in Hong Kong. The sample consisted of 226 women ranging in age from 18 to 60 years. One group of participants was composed of 110 IPV victims, while there were 116 general women patients in the other who were not IPV victims. The statistical properties of the instruments were analysed to ascertain their internal consistency, test/re-test reliability, concurrent validity, discriminant validity and construct validity. The results of data analysis indicated that the E-HITS was highly reliable, with a Cronbach's alpha of .90. The two-week test/re-test reliability was .831 (p<0.001). Participants' scores on the E-HITS correlated positively with those on the PVS, the B-SAFER and the psychological aggression, physical assault, sexual coercion and injury scales; and correlated negatively with the negotiation scales of the Revised Conflict Tactics Scale at a statistically significant level. Subsequent receiver operating characteristic (ROC) curve power analysis revealed that E-HITS reaches a sensitivity of 98.2% and a specificity of 94.8% at a cut-off of 8.5. The overall accuracy of the E-HITS indicated by the area under the curve in the ROC was .991. The predictive value was 95% for self-reported IPV victims and 98.1% for non-IPV victims. The positive and negative likelihood ratios were 18.89 and 0.02, respectively. Factor analysis identified one factor with an associated eigenvalue of 3.598; the total variance accounted for by the first factor was 71.97%. The one factor structure of the E-HITS was also supported by the Scree Test. These results show that the E-HITS has good internal consistency, test/re-test reliability, concurrent and discriminant validity, and a unidimensional factor structure. The E-HITS is a valid and reliable tool for IPV screening of female patients in the EDs of hospitals in Hong Kong. The results of this study may help healthcare providers to distinguish IPV victims from the non-victim group.

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