Violence experienced by women results in significant morbidity and, in some cases, mortality. The experience of sexual abuse as a child has been linked to later development of psychological disorders 1 and drug abuse and dependence. Because of these associations and because victims of violence are more likely to turn to doctors for help than to any other person, 8 they are highly likely to frequent a Physical-sexual surgery. However, doctors are not skilled at recognising them and have been estimated to diagnose only one battered woman in Physical-sexual may occur because doctors are unaware of the extent of physical and sexual abuse experienced by their female patients; while the prevalence has been studied in the United States and Europe, Australian data are sparse.
The single authoritative study on the prevalence of childhood sexual abuse in Australia was conducted by Goldman and Goldman on a population of university students: The aim of our study was to determine the prevalence of domestic violence, childhood abuse and sexual assault experienced by women attending general practitioners and Physical-sexual provide doctors with accurate information on the extent of the problem. The study was a questionnaire-based prevalence survey carried out between Physical-sexual and February was approved by the ethics committee of University.
The study population comprised women over the age of 18 attending their general practitioner for a consultation. Fifteen general practices in metropolitan Melbourne were Physical-sexual in a two-stage random sampling design described previously. A total sample size of about women was calculated to "Physical-sexual" necessary to ensure adequate power, based on results of a pilot study; questionnaires were therefore distributed to each practice.
Consecutive women attending the practice for a consultation were invited to participate by the practice receptionist. The questionnaire was Physical-sexual by a covering Physical-sexual, which explained the nature of the study, Physical-sexual it was Physical-sexual and confidential, and Physical-sexual the information disclosed would not be entered in their medical file or given to their doctor.
It was acknowledged that some questions might cause distress, and the questionnaire Physical-sexual therefore be completed either in the waiting room or at home and returned in a reply-paid envelope.
Respondents were also given contact phone numbers of support services for the different forms of abuse, and informed that their doctor was "Physical-sexual" to discuss with them any issues that might arise as a result of the survey. Before the study, doctors were given an information package with details of local support services for abused women. The self-administered questionnaire asked first for demographic details.
Respondents then completed Physical-sexual Conflict Tactics Scale, "Physical-sexual" with the modification that they were asked whether the tactic had occurred never, once or more than once Physical-sexual the last year, and with the addition of questions on emotional abuse. In accordance with the Conflict Tactics Scale, physical violence was classified as minor or severe see Box 1.
Questions about sexual abuse were derived from the studies of Wyatt 14 and Russell,both of 15 which used multiple screening questions to allow time for the respondent to become accustomed to the nature of the questions.
Childhood sexual abuse was classified as contact or non-contact Box 1. Data were entered into a Microsoft Access database. Frequency tables were generated and prevalences calculated. Because the data came from 15 different general practices and not a simple random sample, confidence intervals CIs were adjusted for the of clustering.
Prevalences for the different categories of domestic violence in the previous year are shown in Box 2. Only those women in a current relationship were asked to complete the section about domestic violence, so that the sample size was smaller than for other parts of the study.
Prevalences of different forms of abuse are shown in Box 3. Reasons given for not disclosing are shown in Box 5. We believe that this study is the first show the prevalence of physical, sexual and emotional abuse of women in an Australian general practice population.
While we recognise Physical-sexual domestic violence and sexual abuse are not exclusively directed by men against women, the study found Physical-sexual high Physical-sexual of violence against women.
Despite these levels, few women disclose Physical-sexual events to their doctors. In fact, our findings may underestimate the true prevalence of domestic violence, as women who were Physical-sexual or divorced were not questioned about their experience of it.
Potential sources of bias exist. Because of the secret nature of physical and Physical-sexual abuse and the stigma attached, there is much controversy over whether self-disclosure by Physical-sexual can give a true indication of prevalence.
A Physical-sexual questionnaire gives no opportunity for clarification of responses by an interviewer. It is also argued that victims will not respond because they fear Physical-sexual disclosure will cause further trauma. These factors would Physical-sexual apparent prevalence. Another possible source of bias is that the self-administered questionnaire format may have precluded the participation of women from non-English-speaking backgrounds.
Importantly, about three-quarters of respondents had never been asked by their doctors about domestic violence or childhood physical abuse. This is consistent with results of studies in other countries, which show physician enquiry rates into spouse abuse to be suboptimal.