Medical Council of Canada

Medical expert

Adult Abuse / Intimate Partner Abuse - 114-3

Rationale

Adult or intimate partner abuse is a common problem that can occur in all partnerships. Abuse is often kept hidden by the victim and may be difficult to diagnose, yet it causes significant physical and emotional morbidity. It can also lead to the death of the abused spouse.

Causal Conditions

(list not exhaustive)

Abuse may be classified into several types:

  1. Physical abuse
  2. Psychological abuse
  3. Emotional abuse
  4. Social isolation
  5. Sexual abuse
  6. Economic

Key Objectives

Given a case of possible adult or intimate partner abuse, the candidate will diagnose the cause, severity and complications, and will initiate an appropriate management plan. In particular, the candidate will assess immediate and short-term risk to the victim, and devise a safe and effective plan for the patient.

Enabling objectives

Given a case of possible adult or intimate partner abuse, the candidate will

  1. list and interpret critical clinical findings, including those based on
    1. the identification of possible factors putting the patient at increased risk of abuse (e.g., pregnancy, threat to leave);
    2. whether the partner has risk factors for being violent (e.g., substance use);
    3. the varied nature of symptoms and signs that may indicate potential abuse (e.g., recurrent nature);
    4. the nature of the interaction between partners as well as the importance to interview and examine the patient alone;
    5. the level of immediate-and-short term danger for the individual as determined through an assessment of risk factors for lethality or serious injury;
  2. list and interpret critical investigations, including
    1. the careful documentation of the location and nature of injuries and appropriate investigation of physical injuries via physical examination and other tests, as needed;
  3. construct an effective initial management plan, including
    1. maintaining an empathic relationship;
    2. ensuring confidentiality and communicate exceptions;
    3. assisting the individual in devising a safety plan;
    4. giving information regarding access to transition housing, and support services;
    5. arranging supportive follow-up.
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