Violence against women in North-East Piedmont, Italy: a cross-sectional study on patients accessing the emergency department (2017-2020).

introductionViolence against women (VaW) is a form of gender-based violence (GBV), a violation of human rights, and a public and global health issue. VaW leaves short and long-term sequelae on the health of survivors and necessitates correct clinical and forensic management. Victims of GBV can access care through the emergency department (ED), which is often the setting where disclosure of abuses occurs. This study aimed at documenting the epidemiology of patients accessing the ED for cases of VaW, as well as to understand the best practices and issues encountered in different health facilities in North-East Piedmont, Italy. This could contribute to documenting local data on the characteristics of survivors of VaW accessing emergency care, as well as to understanding the challenges encountered by healthcare staff in managing and documenting these cases at the ED level.

methodsA retrospective, cross sectional study covering the years 2017-2020 in different hospitals in North-East Piedmont (Novara, Borgomanero, Biella, Verbania-Cusio-Ossola) was conducted. Data on adult female patients (age > 18) was extracted in anonymized form from health facilities' databases and analyzed using Stata18. Descriptive statistics summarized the characteristics of the pool of users and access to the ED. RESULTS AND

conclusionsPatients accessing care in different EDs in North-East Piedmont described in many cases episodes of physical or physical and psychological violence perpetrated by partners in their homes. Many cases of minors witnessing violence were reported. Data from the years 2017-2020 showed that improvements were still needed in the management of GBV survivors in the ED, especially for what concerned assignment of triage color codes, proper documentation of the dynamics of violence, of the physical lesions, and other health sequelae. WHAT IS ALREADY KNOWN: Victims of gender-based violence may access care through the Emergency Department. Healthcare providers in Emergency Departments are often the first professionals to whom victims disclose violence. They should be trained to identify victims of gender-based violence following existing guidelines and referrals to specialists should be available. Violence against women is a recognized public health issue that can lead to serious clinical and social consequences for women. WHAT THIS PAPER ADDS: This paper describes the characteristics of patients accessing emergency care for cases of violence against women in Northeast Piedmont. This paper demonstrates that the triage, documentation of injuries, and referral practices regarding victims of gender-based violence in the Emergency Department need improvement. This paper shows the issues connected with documentation of the sequelae of gender-based violence in Emergency Departments.