Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Barriers to Screening and Disclosure

There are significant barriers to screening and disclosure from both the client’s and clinician’s perspective. It is necessary for the nurse to understand these barriers.

Some barriers for screening from the provider’s perspective include:

  • Fear of opening “Pandora’s Box”;
  • Fear of offending the patient;
  • Heterosexism, classism, racism;
  • Time constraints;
  • Don’t know what to do if the abuse is confirmed;
  • Believe that attempts to help are futile;
  • Not in my practice setting” mentality;
  • Believe the victim caused the abuse; and
  • Lack of awareness of woman abuse including: Not recognizing some acts of violence as abuse and lack of organizational support.

Some barriers for disclosure from the client’s perspective include:

  • The children;
  • Cultural or religious values;
  • Fear of violence/retaliation if the abuser finds out about disclosure;
  • Isolation;
  • Fear about immigration status;
  • Concern partner will be arrested;
  • Stigmatization if only certain women are asked;
  • Hope that the partner will change; and
  • Lack of knowledge of available resources.

Reference: The Medical Subcommittee of the Delaware Domestic Violence Coordinating Council (DVCC) (2000). Domestic violence: A resource manual for healthcare providers for the State of Delaware: Part 3: Healthcare provider’s response. Delaware Medical Journal, 72, 527-534.