e 12 questions considered together:
• e 12 questions are considered useful as the instrument is short and helps in raising awareness.
To all questions a part could be added asking about the person’s relationship with the perpetrator.
A change of order was not considered to be important.
e issue of abandonment should be addressed more explicitly in one of the questions.
Some questions could be combined, for example Questions 5 and 11.
Since the frequency of abuse plays an important role, categories such as “al- ways”, “hardly ever” and “never” could be added to each question.
It was pointed out that such an instru- ment could not be applied to cognitively impaired patients. e question was raised of how to handle such cases if there is a suspicion of abuse.
How should a PHC professional react if there is a suspicion of abuse but the potential victim is not willing to de- nounce the perpetrator or to be referred for further action?
Many older people feel uncomfortable when requesting help, either because they want to stay independent or be- cause they are afraid of being rejected. is factor can hamper the detection of abuse.
Question 11: is question is very im- portant and relevant for the detection of physical abuse. It is considered to be clear and comprehensible. A difficulty is to de- termine whether the abuse was intentional or accidental. e frequency of abuse needs further specificity.
e term “hurt” could be replaced with
“injured” or “attacked” in order to empha- size the physical aspect of the abuse. e question could be followed by “What is your relationship with this person?”
Question 12: is question is clear and very relevant for the suspicion of sexual abuse, and the participants agreed that it is important to have a question on such abuse. However, they doubted whether the interviewee would answer truthfully a question that tackles such a delicate is- sue. Furthermore, this question requires a relationship of trust between the doctor and the patient and probably can be asked only after several visits. When asking this question, it is crucial to have follow-up strategies in place to ensure an appropriate referral.
e second part of the question (“Was this
an isolated event?”) can help to evaluate the person’s risk.