Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000–2015

Aims and objectives - Our aim was to identify, review and critically evaluate published empirical studies concerned with the prevalence, management and support for survivors of DVA who present at ED.

Background - DVA is a global phenomenon with a wealth of studies that explore the different aspects of the issue including the economic, social and health effects on survivors and on society as a whole. ED is widely recognised as one healthcare facility where DVA survivors will often disclose DVA. In the UK, NICE produced guidelines in 2014 requiring all sectors of healthcare and those they work alongside to recognise support and manage survivors of DVA. Whilst there is an increasing body of research on DVA, limited synthesised work has been conducted in the context of DVA within ED.

Design - This review encompasses empirical studies conducted in ED for screening interventions, management and support for DVA patients including prevalence. This review included studies that included ED staff, ED service users and DVA survivors.

Methods - A systematic approach across five electronic bibliographic databases found 35 studies meeting the inclusion criteria published between 2000 and 2015.

Results - From the 35 studies four descriptive overarching themes were identified (1) prevalence of DVA in ED, (2) Use of DVA screening tools and ED interventions, (3) current obstacles for staff working in ED and (4) ED users and survivor perspectives.

Conclusions - Having knowledgeable and supportive ED staff can have a positive benefit for the longer term health of the DVA survivor who seeks help. The physical characteristics of DVA are often easier to identify and manage but emotional and psychological aspects of DVA are often more complex, and difficult for staff to identify. This therefore raises questions as to what approaches can be used, within these busy settings, when often survivors do not want to disclose.