Abused case

In my country-Thailand the abused problem cannot be accurate determine. However the prevalence seem less than US which one study reports that 29% of women and 22% of men report having experienced physical, sexual, or psychological intimate partner violence during their lifetime !!

Abused case

Ask: I see your bruise, can you tell me about it
or I normally ask my patients about being abused because the abuse of women
(elder/children) usually occurs in our society nowadays. Please feel free to tell me, I will
keep everything confidential.- Have you ever been abused by your spouse(child/parents)?
Address: with SAFE
Advise: You don’t deserve to be beaten, battering is against the law. And the onlyway to end abuse is to get away from batterer.
Assist: I care about your safety.
Would you like to speak with our counselor.
Here is a phone number of supported group

Suspected situation
1.Injury with delayed seeking treatment
2.Multiple uncovered bruise
3.Chronic vage symptom eg. Headache, fatigue without explanation
4.Sexual related complaint
5.Emotional problem eg. Depression, Anxiety
6 Over controled by caretaker(who is a batterer)


Main Idea of SAFE
It's important for physician are concerned of the patients safety and health and also
of her children if she has children.(Most of the time pts are in denial) Inform pt
the importance of having an emergency plan and informing family/freinds on her problem.
And you also inform patient of help via support groups and resources for ppl who suffered
from domestic abuse. And if there is abuse of children, tell the patient you have to inform
child protective services
original SAFE from http://emedicine.medscape.com/article/805546-overview
Stress/Safety: Do you feel safe in your relationships (marriage)?
Should I be concerned for you and your children safety?
Afraid/Abused: Do any situations exist in your relationships in which you have felt afraid?
Have you been physically hurt by your partner?
Friends/Family (assessing degree of social support):
If you have been hurt, are your friends or family aware of it?
Do you think you could tell them if it did happen?
Emergency plan: Do you have a safe place to go and the resources you (and your children) need
in an emergency?

Short version SAFE
from GATO (http://forums.studentdoctor.net/showthread.php?t=570107)
Safe: “Are you concerned about safety of you and your children?”
Afraid: “Do you feel afraid?”
Friends/Family: “Do you have friends and family support”
Emergency plan: “Do you have an emergency plan?” - If say no, give consult