Domestic violence screening in Spanish — ED, primary care, and OB nurses

Domestic violence screening in Spanish: HITS, safety assessment, mandatory reporting, and safety planning — phrase by phrase.

Intimate partner violence screening in Spanish carries a unique double barrier: language and safety. A patient who cannot understand your questions may nod. A patient whose partner is in the room cannot answer honestly in any language. And a patient who fears ICE, family shame, or losing housing may not disclose even when safe to do so. This page gives you the specific phrases for universal IPV screening, the HITS questionnaire in Spanish, lethality assessment, mandatory reporting disclosure, and safety planning — with the cultural framing that makes disclosure more likely, not less.

Before you screen: privacy and framing

IPV screening is never done with anyone other than the patient in the room. This is not a preference — it is a safety requirement. If a partner or family member is present, they must leave before any screening question is asked.

• Necesito hablar con usted a solas por un momento — es parte del examen de rutina que hacemos con todos nuestros pacientes. — I need to speak with you alone for a moment — it is part of the routine exam we do with all our patients. (Say this directly to the patient while the partner/family is still present.)
• Le hago estas preguntas a todos mis pacientes — hombres, mujeres, mayores, jóvenes. No es porque sospecho algo — es parte del cuidado de salud que doy a todas las personas. — I ask these questions of all my patients — men, women, older, younger. It is not because I suspect anything — it is part of the health care I give to everyone.
• Lo que me diga aquí es confidencial. Hay excepciones que le voy a explicar si es necesario — pero nadie que vino con usted hoy va a escuchar lo que me diga. — What you tell me here is confidential. There are exceptions I will explain if necessary — but no one who came with you today will hear what you tell me.

HITS screening tool in Spanish

HITS is a validated four-item IPV screening tool. Score: 1 = never, 2 = rarely, 3 = sometimes, 4 = often, 5 = frequently. Total ≥11 is a positive screen.

• H — Hurt: ¿Con qué frecuencia su pareja le hace daño físicamente — la golpea, la empuja, la lastima de cualquier manera? — How often does your partner physically hurt you — hit you, push you, injure you in any way?
• I — Insult: ¿Con qué frecuencia su pareja la insulta o habla sobre usted de forma irrespetuosa o humillante? — How often does your partner insult you or speak about you in a disrespectful or humiliating way?
• T — Threaten: ¿Con qué frecuencia su pareja la amenaza con hacerle daño — a usted, a sus hijos, o a sí mismo? — How often does your partner threaten to harm you — you, your children, or themselves?
• S — Scream: ¿Con qué frecuencia su pareja le grita, la asusta, o la hace sentir miedo en casa? — How often does your partner scream at you, frighten you, or make you feel afraid at home?
• A score ≥11 is a positive screen. A score ≥8 with a pattern of escalation warrants clinical concern. Any single "often" or "frequently" on threat or physical harm warrants lethality assessment.

Lethality and danger assessment

After a positive HITS screen, assess for high-danger indicators. These questions predict severe violence and femicide risk. Ask them directly — hedging the language reduces the accuracy of the patient's answer.

• ¿Su pareja alguna vez ha usado armas para amenazarla o lastimarla — armas de fuego, cuchillos, u otras? — Has your partner ever used weapons to threaten or hurt you — firearms, knives, or others? (Weapon use — highest lethality factor)
• ¿La ha amenazado de matarla alguna vez — a usted, a sus hijos, o a sí mismo? — Has your partner ever threatened to kill you — you, your children, or themselves? (Death threat)
• ¿Usted siente que él o ella es capaz de matarla? — Do you feel he or she is capable of killing you? (Patient perception — highly predictive of lethal violence)
• ¿Han aumentado los episodios de violencia en los últimos meses, o se han vuelto más graves? — Have the episodes of violence increased in recent months, or become more severe? (Escalation)
• ¿Hay armas de fuego en la casa? — Are there firearms in the home? (Firearm access doubles femicide risk)
• ¿Usa alcohol o drogas su pareja? — Does your partner use alcohol or drugs? (Substance use by abuser significantly increases lethality)

Responding to a positive screen — affirming the patient

The response to disclosure determines whether the patient will engage further or shut down. Avoid expressions of horror, urgency pressure, or advice-giving as the first response.

• Le agradezco que me haya dicho esto. No fue fácil decirlo, y lo que me dijo es importante. — I appreciate you telling me this. That was not easy to say, and what you told me is important.
• Lo que está pasando no es culpa suya — no hay nada que usted haya hecho para merecer esto. — What is happening is not your fault — there is nothing you have done to deserve this.
• No le voy a decir qué tiene que hacer — esa es su decisión. Lo que sí quiero es asegurarme de que tenga información y opciones. — I'm not going to tell you what you have to do — that is your decision. What I do want is to make sure you have information and options.

Mandatory reporting disclosure

Mandatory reporting requirements vary by state. Always tell the patient what will be reported before reporting it — this is both an ethical and, in many states, a legal requirement.

• Quiero ser honesta con usted sobre lo que la ley me exige hacer. — I want to be honest with you about what the law requires me to do.
• En este estado, cuando veo lesiones que pueden ser por violencia, tengo la obligación de hacer un reporte a las autoridades. — In this state, when I see injuries that may be from violence, I have an obligation to make a report to authorities.
• Ese reporte no significa que van a arrestar a alguien esta noche, ni que van a ir a su casa. Significa que hay un registro oficial. — That report does not mean someone will be arrested tonight, or that anyone will go to your home. It means there is an official record.
• Usted decide si quiere hacer una denuncia formal con la policía — eso es completamente su decisión. — You decide whether you want to make a formal police complaint — that is completely your decision.
• Lo que nunca voy a hacer es llamar a su casa o decirle a su pareja que usted habló conmigo. Esta conversación es entre usted y yo. — What I will never do is call your home or tell your partner that you spoke with me. This conversation is between you and me.

Safety planning in Spanish

If she plans to stay

• Si usted decide quedarse en casa, hay cosas que puede hacer para estar más segura si la situación se pone peligrosa. — If you decide to stay home, there are things you can do to be safer if the situation becomes dangerous.
• ¿Tiene un lugar adonde podría ir esta noche si fuera necesario — casa de un familiar, una amiga, en otra ciudad? — Do you have a place you could go tonight if necessary — a family member's home, a friend's, in another city?
• ¿Tiene documentos importantes guardados en un lugar separado — su identificación, tarjetas de crédito, acta de nacimiento de sus hijos? — Do you have important documents stored in a separate place — your ID, credit cards, your children's birth certificates?

If she plans to leave

• Si decide irse, hay recursos que pueden ayudarla — refugios, ayuda legal, y personas que entienden exactamente lo que está pasando. — If you decide to leave, there are resources that can help you — shelters, legal aid, and people who understand exactly what is happening.
• La Línea Nacional sobre Violencia Doméstica — el número es 1-800-799-7233 — tiene personas en español disponibles las 24 horas, todos los días. — The National Domestic Violence Hotline — the number is 1-800-799-7233 — has Spanish-speaking staff available 24 hours, every day.
• También puede textear la palabra START al 88788 si no puede hablar. — You can also text the word START to 88788 if you cannot speak.

Emergency safety

• Si está en peligro inmediato, llame al 911. Los despachadores en muchas ciudades tienen acceso a intérpretes de español. — If you are in immediate danger, call 911. Dispatchers in many cities have access to Spanish interpreters.
• Si no puede hablar, puede toser, hacer ruido, o decir que necesita una ambulancia — el despachador entenderá que hay una emergencia. — If you cannot speak, you can cough, make noise, or say you need an ambulance — the dispatcher will understand there is an emergency.

Cultural considerations for Latino patients

Several cultural dynamics are common enough in Spanish-speaking patient populations to warrant naming directly — not as assumptions, but as contexts to hold open.

• Fear of deportation: Undocumented patients may fear that calling 911 or making a police report will result in immigration consequences for themselves or their partner. Name this fear directly: "Si está preocupada por su estatus migratorio, hay organizaciones que pueden ayudarla sin involucrar a la policía. ¿Quiere que le dé ese número?"
• Family loyalty (familismo): Leaving may be perceived as betraying the family. "Proteger su seguridad — y la de sus hijos — no es traición. Es lo que necesita para que la familia siga existiendo."
• Religious framing: Some patients feel that leaving violates religious obligations. "Muchas personas de fe — sacerdotes, pastoras — dicen que Dios no pide que usted soporten la violencia. Hay recursos que pueden conectarla con consejeros de fe que entienden esto."
• Economic dependency: Many survivors stay because they cannot afford to leave. Acknowledge this directly: "Entiendo que la situación económica hace esto más complicado. Hay organizaciones que ayudan específicamente con vivienda, trabajo, y cuidado de los niños."

FAQs — domestic violence screening in Spanish

ClinicaLingo is a language-training product, not medical interpretation. Domestic violence screening with Spanish-speaking patients should be conducted with a qualified interpreter — never with a family member, partner, or anyone the patient did not choose independently. Follow your facility's IPV screening protocol and mandatory reporting requirements for your state.