consider the possibility of domestic violence - to identify domestic violence try asking a 'lead in' question e.g. "do you ever feel afraid of your partner?"
emphasise confidentiality
ask about domestic violence - evidence suggests that women who are not being subjected to domestic violence do not mind being asked, and that women who are being subjected to domestic violence do want to be asked;
accurate documentation is essential
if possible, photographs should be taken of all patients with visible injuries;
allow the patient to tell her story.
information provider role - explain that the patient has legal rights - violence in the home is as illegal as violence in the streets;
devise a safety plan - the patient should not be pressurised into following any specific action. Encourage and respect the patient's individual autonomy, self-determination and self-esteem.
Reference:
RCGP - Domestic violence: the general practitioner's role by Dr Iona Heath.
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