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Patient Opinions of Screening for Intimate Partner Violence in a Fracture Clinic SettingP.O.S.I.T.I.V.E.: A Multicenter Study
Sheila Sprague, MSc1; J. Carel Goslings, MD, PhD2; Brad A. Petrisor, MD, MSc, FRCSC1; Victoria Avram, MD, FRCSC1; Olufemi R. Ayeni, MD, MSc, FRCSC1; Emil H. Schemitsch, MD, FRCSC3; Rudolf W. Poolman, MD, PhD4; Kim Madden, BSc1; Katelyn Godin1; Sonia Dosanjh, MSW5; Mohit Bhandari, MD, PhD, FRCSC1; (for the P.O.S.I.T.I.V.E. Investigators)
1 Department of Clinical Epidemiology and Biostatistics (S.S., K.M, M.B.) and Division of Orthopaedic Surgery, Department of Surgery (B.A.P, V.A., O.R.A., K.G., M.B.), 293 Wellington Street North, Suite 110, Hamilton, ON L8L 8E7, Canada. E-mail address for S. Sprague: sprags@mcmaster.ca. E-mail address for B.A. Petrisor: petrisor@hhsc.ca. E-mail address for V. Avram: avramv@hhsc.ca. E-mail address for O.R. Ayeni: femiayeni@gmail.com. E-mail address for K. Madden: maddenk@mcmaster.ca. E-mail address for K. Godin: katelyn.mgodin@gmail.com. E-mail address for M. Bhandari: bhandam@mcmaster.ca
2 Trauma Unit, Department of Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. E-mail address: j.c.goslings@amc.uva.nl
3 Division of Orthopaedic Surgery, St. Michael’s Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada. E-mail address: schemitsche@smh.toronto.on.ca
4 Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC, Oost en Watergraafsmeer, Amsterdam, The Netherlands. E-mail address: poolman@trauma.nl
5 Global Research Solutions, 206-3228 South Service Road, Burlington, ON L7N 3H8, Canada. E-mail address: sonia.dosanjh@grsolutions.ca
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  • Disclosure statement for author(s): PDF

Investigation performed at Hamilton Health Sciences (General, McMaster, and Chedoke Sites), Hamilton, Ontario, Canada; St. Michael’s Hospital, Toronto, Ontario, Canada; and Academic Medical Center, Amsterdam, The Netherlands

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Jul 03;95(13):e91 1-10. doi: 10.2106/JBJS.L.01326
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Approximately one-third of injured women presenting to fracture clinics have experienced some form of intimate partner violence in the past year. The aim of the current study was to determine patients’ perceptions on screening for intimate partner violence during visits to a surgical fracture clinic.


We conducted a cross-sectional study to evaluate patients’ perceptions and opinions on screening for intimate partner violence in an orthopaedic fracture clinic. Eligible patients anonymously completed a self-reported written questionnaire, which included questions on patient demographics, attitudes toward intimate partner violence in general, the acceptability of screening for intimate partner violence in an orthopaedic fracture clinic, and opinions on how, when, and by whom the screening should be conducted.


The study included 750 patients (421 male and 329 female) at five clinical sites in Canada and the Netherlands. The majority (554, 73.9%) of the respondents either “agreed” or “strongly agreed” that the fracture clinic was a good place for health-care providers to ask about intimate partner violence. The majority (671, 89.5%) also agreed that health-care providers should screen for intimate partner violence by means of face-to-face interactions rather than other, more passive methods. Increased openness to screening was significantly associated with female sex, higher income, and higher education (F3595 = 21.950, p < 0.001).


Our findings demonstrated that the majority of patients endorse active screening for intimate partner violence in orthopaedic fracture clinics.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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