Recognition Of Intimate Partner Violence Research Articles

Assessment of Emergency Department Health Care Providers’ Readiness for Managing Intimate Partner Violence and Correlation With Perceived Cultural Competence

IntroductionIntimate partner violence is a public health problem, and emergency departments are often a victim’s only contact with health care providers. Despite this, recognition of intimate partner violence within emergency departments remains low owing, in part, to barriers experienced by providers. To better understand these barriers, this study examined relationships between readiness for managing intimate partner violence and cultural competence among emergency department health care providers. MethodsA cross-sectional, correlational study was conducted in 3 emergency departments. Eligible participants included registered nurses, physicians, physician assistants, nurse practitioners, and residents. Data were collected through an anonymous online self-report survey. Descriptive statistics and correlation analyses were conducted to answer study aims. ResultsOur sample included 67 respondents. More than one-third (38.8%) reported no previous intimate partner violence training. Those with previous training had higher readiness scores. Physicians were found to have higher intimate partner violence knowledge scores than registered nurses. Cultural competence scores were generally positive across domains. Aspects of intimate partner violence readiness were associated with culturally competent behaviors, communication, and practices. DiscussionOverall, participants were found to have low perceived readiness scores. Those with previous intimate partner violence training were found to have greater readiness in practice, suggesting that standardization of screening practices and intimate partner violence-related training should be the standard of care. Our data also suggest that perception of culturally competent behaviors and communication are learned skills that can increase screening rates within the emergency department.

What do the Public Understand About Intimate Partner Violence in the Context of Military Veteran Status and PTSD?

Intimate Partner Violence (IPV) represents a significant public and social health concern and may present particular complexities in military veteran relationships which are subject to unique stressors including separations, transition to civilian life and increased risk of Post-Traumatic Stress Disorder (PTSD). Public understanding is vital in terms of ensuring access to services and appropriate intervention. However, little is known about the public perception of IPV in this context. This study sought to assess how public recognition and discourse is affected by military veteran status and a diagnosis of PTSD. Community participants (N = 269) were randomly allocated to one of four conditions and presented with a story containing IPV in which the profession (military veteran/civilian worker) and diagnostic status (PTSD/No PTSD) were manipulated. All participants rated the extent to which they felt the story contained IPV; additionally, half (n = 123) took part in a story completion task designed to elicit qualitative data with regards to public discourse. The mean scores in all conditions were weighted towards IPV recognition. Results indicated a small interaction between job role and PTSD (F[1265] = 7.888, p < 0.01, partial n2 = 0.029) meaning that the public are more likely to recognise IPV when it is perpetrated by a military veteran than a civilian with PTSD. Diagnostic status made no difference to recognising abuse perpetrated by a military veteran. However, the fit of the model was weak (r2 = .040) meaning that the large majority of variance was due to factors not accounted for. Qualitative findings indicated that in a military population trauma may be assumed even where not indicated and the public appear less likely to consider current stressors or acknowledge that PTSD cannot justify abuse. Victims of IPV in military relationships may therefore be particularly vulnerable to discourses that prioritise the victim status of the perpetrator.

Naming and Recognition of Intimate Partner Violence and Family of Origin Violence Among LGBTQ Communities in Australia.

Dominant framings of intimate partner violence (IPV) construct the experience as one where a cisgender man enacts violence against a cisgender woman. While often the case, this framing obfuscates the experiences of people who identify as lesbian, gay, bisexual, transgender diverse, or queer (LGBTQ) and may challenge their ability to conceive of their relationship-based experiences as abusive or violent. The extent to which hostile experiences from family of origin violence (FOV) members are conceived or named as violence is also unclear. A large, online, national survey of LGBTQ adults separately assessed experiences of IPV and FOV in two ways: a direct question relating to abuse from a partner/s or family member/s, and a second question (asked irrespective of the previous answer) which sought to establish experience of a nuanced list of abusive acts that can constitute violence (including emotional abuse, LGBTQ-specific forms of violence, and enforced social isolation). Following comparison of responses, multiple regression analyses were performed to assess variation by demographic characteristics. Among the full sample of 6,835 individuals, when asked directly, 30.93% (n = 2,108) of participants indicated that they had ever experienced FOV and 41.73% (n = 2,846) indicated that they had ever experienced IPV. However, when asked about experiences of FOV using the second nuanced question, 43.18% (n = 2,675) responded in ways that indicated that they had ever experienced FOV and 60.71% (n = 3,716) with respect to IPV. The recognition of violence, as indicated by responses to the direct question varied by numerous characteristics, including age, gender, and educational attainment. These findings indicate some LGBTQ people may struggle to recognize or name their family or relationship experiences as abusive or violent, which may complicate their ability or willingness to access professional support. More expansive framings, policies, and responses to IPV and FOV are required.

Police prosecutors and LGBTIQ intimate partner violence, victims, and perpetrators: an empirical study

This paper reports on a survey exploring whether police prosecutors in the Queensland Police Service can recognise and respond appropriately to intimate partner violence (IPV) in the LGBTIQ community. Utilising an online survey featuring hypothetical vignettes of IPV involving LGBTIQ people, it sought to understand police prosecutors’ recognition of, and response to, IPV situations involving LGBTIQ people; the likelihood of IPV occurring in LGBTIQ relationships; and whether friendships, interaction (social and professional), and levels of trust in LGBTIQ people shape their perceptions of LGBTIQ victims, perpetrators, and IPV itself. Contributing new knowledge into the extant policing literature examining policing of IPV, the results of this study offer a unique insight into police prosecutors and LGBTIQ IPV and their inability to clearly distinguish between perpetrators and victims in LGBTIQ IPV scenarios, particularly where coercive control is involved, or a transgender person is the victim. We argue that enhancing police prosecutors’ recognition of, and response to, IPV situations in the LGBTIQ community is important because of the key role that prosecutors play in LGBTIQ peoples’ access to justice and responding appropriately to their needs as victims and perpetrators. The results from this study have international significance regarding developments in policing policy and practice and IPV recognition, and what this means for operational policing guidelines and better policing response when prosecuting IPV situations involving LGBTIQ people.

Rural Chinese Women’s Recognition of Intimate Partner Violence and their Potential Coping Strategies: A Qualitative Study

Rural Chinese Women’s Recognition of Intimate Partner Violence and their Potential Coping Strategies: A Qualitative Study

Knowledge, attitude, and preparedness toward IPV care provision among nurses and midwives in Tanzania

BackgroundWith increasing recognition of intimate partner violence (IPV) as a public health challenge, nurses and midwives are recognized for their crucial role in providing front-line healthcare services for IPV. This study aimed to evaluate knowledge, attitude, and preparedness related to IPV care provision in health facilities among nurses and midwives in Tanzania.MethodsA self-administered anonymous questionnaire survey was conducted among nurses and midwives working in health facilities in the Mbeya region between December 2018 and January 2019. The questionnaire consisted of questions on their perceived and actual knowledge, attitudes, and preparedness to provide care in relation to IPV.ResultsA total of 662 (50.1%) of 1321 nurses and midwives who worked in hospitals and/or health centers in the Mbeya region participated in this study, and 461 (69.6%) completed questionnaires were included in the analysis. The proportion of nurses and midwives with high scores in IPV perceived knowledge, actual knowledge, attitude, and preparedness to provide care was 59.9%, 53.1%, 54.2%, and 54.0%, respectively. Regardless of the type of facility, gender, educational level, and work experience, the use of IPV guidelines was significantly associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.004), and preparedness to provide care (P < 0.001), but not attitude, which was negatively associated (P = 0.048). Regardless of the type of facility, gender, educational level, and work experience, receiving preservice IPV training was associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.049), and preparedness to provide care (P = 0.002), but not attitude (P = 0.192). Regardless of the type of facility, gender, educational level, and work experience, in-service IPV training was associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.043), and preparedness to provide care (P = 0.001), but not attitude (P = 0.063).ConclusionsAlthough guidelines and training could improve nurses’ and midwives’ knowledge and preparedness to provide care regarding IPV, attitudes against IPV care are a challenge. To improve attitudes regarding IPV among front-line nurses and midwives, it is necessary to address concepts of IPV care and sympathy with potential and actual victims of IPV in pre- and in-service training in addition to providing recall-level knowledge.

Responding to intimate partner violence: Healthcare providers' current practices and views on integrating a safety decision aid into primary care settings.

Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting. Despite recognition of IPV as a problem, none of the clinical sites had a protocol to guide screening and response to IPV disclosure. Screening practices varied across the sites, sometimes conducted by medical assistants prior to the provider visit and other times by the physician or nurse provider. When IPV was disclosed, it was often during assessment for a presenting problem such as poor sleep or anxiety. Most healthcare workers felt that clinical and community resources were limited for their patients experiencing IPV. The "warm hand-off" to a social worker was the most common response strategy when possible; otherwise, women were given information about available resources such as hotlines and safe houses. We discuss structural, family, and individual barriers to accessing safety resources for underserved women and review how an easily accessible safety decision app, such as myPlan, could be a resource for women to safely tailor an action plan for her situation.

A new area of expertise? Incorporating social work with intimate partner violence into Swedish social services organizations

The aim of this article is to map and to analyse the incorporation of social work with intimate partner violence (IPV) into Swedish social services organizations. The empirical material consists of a survey directed at social services managers in 100 municipalities, as well as telephone interviews with IPV coordinators and caseworkers. Departing from institutional theory on organizational change, the development of IPV social work is explored through different aspects of specialization and the arrangement of collaboration within the municipalities. The results indicate that IPV specialization has to some extent been developed in a majority of the municipalities studied. The number of caseworkers assigned to work with IPV is relatively low, however, and a considerable part of IPV social work is handled by other parts of the organizations, particularly in the larger municipalities. It is argued that while there has been movement towards IPV specialization in the social services, it has not resulted in any major organizational change. While specialization, even in small measure, might be seen as recognition of IPV as a specific social problem, it is still to be seen to what extent IPV will grow into an established part of PSS structure.

Physical Intimate Partner Violence and Controlling Behavior in Mexican University Students and Their Attitudes Toward Social Limits

This study explored patterns of controlling behavior, physical violence, and attitudes toward social limits in young Mexican university students in light of the effect that socialization processes have in attitudes toward social norms and violent behavior as indicated in some of the literature. A total of 437 male and female heterosexual participants residing in Ciudad Juárez, Mexico, provided information on their perpetration/victimization experiences of controlling behavior (by means of the Controlling Behaviors Scale) and physical violence (using the Revised Conflict Tactics Scales [CTS2]) and their attitudes toward social limits (using the Attitudes Toward Social Limits scale). Results indicate similar chronicity levels of experienced controlling behavior and physical violence perpetration/victimization between the sexes. Participants expressed major tendency to adjust to a social norm rather than overstepping it. Males tend to overstep social limits more often than females, although no significant linear relationship was found between abusive behavior and attitudes promoting the infringement of social norms. Higher chronicity levels were rather found by dyadic type, relationships with mutual physical intimate partner violence (IPV), and controlling behavior in comparison with relationships where unidirectional violence prevails. Implications of findings involve the acknowledgment of change in dynamics used by more educated young Mexicans, and the recognition of IPV in these populations as a heterogeneous phenomenon for primary and secondary interventions.

Intimate Partner Violence Among Women Diagnosed With Cancer.

There is growing evidence that women diagnosed with cancer can experience intimate partner violence (IPV). This combined experience of cancer and abuse can have a profound effect on health and treatment outcomes for these cancer survivors. The purpose of this literature review was to assess the presence of IPV among female cancer survivors and to provide oncology nurses with clinical guidelines about IPV. A systematic strategy was used to locate original research from 4 databases: CINAHL, PubMed, PsycINFO, and Web of Science. Key words were used to help identify articles that focused on cancer, abuse, treatment decision making, and clinical guidelines. The 10 selected articles that met the inclusion criteria were published between 2005 and 2014. The reviewed studies provided accounts of abusive partner behaviors toward women throughout their cancer trajectory. Global organizations provided the framework for clinical guidelines. Challenges faced by women who are concurrently living with IPV and cancer survivorship can impact treatment decision making and health outcomes. The assessment and recognition of IPV by oncology nurses are essential to help create a clinical environment in which patients feel safe and supported. This review includes clinical guidelines and describes legal considerations for oncology nurses to consider when they address and respond to IPV in their practice. The use of clinical guidelines that focus on IPV can provide standardized care in the oncology setting that can further help to meet the needs of these women.

Reflections on attitudes, experiences, and vulnerability of intimate partner violence among Southeast Asian college women living in United States.

To provide culturally sensitive intimate partner violence (IPV) prevention programs for ethnic groups, a basic foundational understanding of Southeast Asian (SEA) women living in the United States is vital. The purpose of this study was to describe SEA college women's perceptions of IPV and how the women recognize their vulnerability to such violent situations. Qualitative methods using focus group discussions were employed to elicit participants' perceptions. Participants included 18 SEA college women, ages 18-34 (Mean=22; SD=7.22). Transcriptions were analyzed using a content analysis approach. Five themes emerged: recognition of IPV; perception of individual vulnerability to IPV; experience and responses to IPV; help seeking and support system; and strategies used for prevention of IPV. Findings yielded an understanding of intertwined issues of cultural norms associated with IPV, social and economic disparities, and challenges for IPV prevention in SEA communities. Culturally sensitive prevention programs will be more effective by reforming cultural values, while at the same time promoting non-violent relationships and increasing access to services.

Community perceptions of intimate partner violence--a qualitative study from urban Tanzania.

BackgroundIntimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community and health care based interventions, we explored community members' understanding and their responses to intimate partner violence.MethodsA qualitative study using focus group discussions with 75 men and women was conducted in a community setting of urban Tanzania. We analysed data using a grounded theory approach and relate our findings to the ecological framework of intimate partner violence.ResultsThe analysis resulted in one core category, "Moving from frustration to questioning traditional gender norms", that denoted a community in transition where the effects of intimate partner violence had started to fuel a wish for change. At the societal level, the category "Justified as part of male prestige" illustrates how masculinity prevails to justify violence. At the community level, the category "Viewed as discreditable and unfair" indicates community recognition of intimate partner violence as a human rights concern. At the relationship level, the category "Results in emotional entrapment" shows the shame and self-blame that is often the result of a violent relationship. At the individual level, the risk factors for intimate partner violence were primarily associated with male characteristics; the category "Fed up with passivity" emerged as an indication that community members also acknowledge their own responsibility for change in actions.ConclusionsPrevailing gender norms in Tanzania accept women's subordination and justify male violence towards women. At the individual level, an increasing openness makes it possible for women to report, ask for help, and become proactive in suggesting preventive measures. At the community level, there is an increased willingness to intervene but further consciousness-raising of the human rights perspective of violence, as well as actively engaging men. At the macro level, preventive efforts must be prioritized through re-enforcement of legal rights, and provision of adequate medical and social welfare services for both survivors and perpetrators.

The early recognition of intimate partner violence by paramedics

The early recognition of intimate partner violence by paramedics

Addressing Intimate Partner Violence in Primary Care: Lessons From Chronic Illness Management

Though many studies have documented the high prevalence, morbidity, mortality and costs attributable to intimate partner violence (IPV), it is still unclear how our health care system should address this major public health problem. Many have advocated for routine screening, yet there is still insufficient evidence that routine IPV screening can lead to improved outcomes. Though recognition of IPV is very important, a screening paradigm may not be the optimal way to approach IPV within the health care system. For many patients, exposure to violence is a chronic condition, characterized by long-term abusive relationships, histories of childhood and community violence, multiple associated chronic symptoms, and extra barriers to addressing their other chronic illnesses. Thus, there may be important lessons to be learned from work being done in the area of chronic care. We explore how Wagner's Chronic Care model may guide efforts to improve health care for IPV survivors and may serve as a framework for future research studies.

Secondary Prevention of Intimate Partner Violence

Despite the recognition of intimate partner violence (IPV) against women as a global health issue associated with significant morbidity and mortality, evidence-based treatment strategies for primary care settings are lacking. To assess the comparative safety behaviors, use of community resources, and extent of violence following two levels of intervention. A randomized, two-arm, clinical trial was completed in urban public primary care clinics with 360 abused women who assessed positive for physical or sexual abuse within the preceding 12 months. Two interventions were tested: a wallet-sized referral card and a 20-minute nurse case management protocol. Outcome measures were differences in the number of threats of abuse, assaults, danger risks for homicide, events of work harassment, safety behaviors adopted, and use of community resources between intervention groups over a 24-month period. Two years following treatment, both treatment groups of women reported significantly (p <.001) fewer threats of abuse (M = 14.5; 95% CI 12.6, 16.4), assaults (M = 15.5, 95% CI 13.5, 17.4), danger risks for homicide (M = 2.6; 95% CI 2.1, 3.0), and events of work harassment (M = 2.7; 95% CI 2.3, 3.1), but there were no significant differences between groups. Compared to baseline, both groups of women adopted significantly (p <.001) more safety behaviors by 24 months (M = 2.0; 95% CI 1.6, 2.3); however, community resource use declined significantly (p <.001) for both groups (M = -0.2; 95% CI -0.4,-0.2). There were no significant differences between groups. Disclosure of abuse, such as what happens with abuse assessment, was associated with the same reduction in violence and increase in safety behaviors as a nurse case management intervention. Simple assessment for abuse and offering of referrals has the potential to interrupt and prevent recurrence of IPV and associated trauma.

Physician-Identified Barriers to Intimate Partner Violence Screening

Intimate partner violence (IPV) causes approximately 2 million injuries and 1300 deaths each year. Despite the high frequency of IPV among women seeking healthcare, only a small proportion report being asked by healthcare professionals about abuse. This study examined perceived barriers to IPV screening among obstetricians/gynecologists, family physicians, and internists, so that protocols for IPV training can be tailored to those particular areas of difficulty. A cross-sectional survey of 143 obstetricians and gynecologists, family practice physicians, and internists in a medium-sized upstate New York city was conducted. Factor analysis was performed. Two IPV barrier domains emerged and were examined using a multivariate analysis to determine associations between the domains and physician characteristics. For general knowledge, there were greater perceived barriers if the respondent was male but fewer perceived barriers if the respondent was an obstetrician/gynecologist and fewer perceived barriers if the respondent had 5-10 years in practice. For practice policy, there were greater perceived barriers if the physician was in a private practice setting and fewer perceived barriers if the physician was an obstetrician/gynecologist. These findings provide direction for training in IPV recognition. They support a need for continued training throughout the physician's career. More importantly, the findings support a need for better practice systems to encourage routine screening for IPV by healthcare providers.

Barriers Limiting Clinician Recognition of Intimate Partner Violence

One in three ever-married women in Nova Scotia faces assault from an intimate partner in her lifetime, making woman abuse a major public health concern. The role of physicians and medical students in the health care system allows them to address this epidemic, yet a number of barriers diminish their ability to deal with domestic violence, also referred to as intimate partner violence (IPV). Using case-reports, personal correspondence, consensus statements, conference proceedings and clinician publications, this article uniquely presents a systematic review of most known barriers which clinicians face in dealing with intimate partner violence. This study examines personal factors, dissonance between clinician views of private versus public spheres, and structural constraints (such as remuneration and work schedules) as reasons mitigating limited clinician attention to intimate partner violence. Barriers related to medical education and traditional medical curricula, as well as problems facing reform of medical education are presented. Lastly, clinician misconceptions and misinformation and professional circumstances are examined as barriers to IPV recognition. This study shows that there are still numerous personal, educational and structural barriers limiting clinician ability, motivation and support to deal with one of the most prevalent health and social problems facing women. This paper concludes that greater attention needs to be focused within medical education, resident education, and continuing medical education on issues surrounding IPV. Whereas this study identifies numerous barriers facing the recognition of IPV, it remains an important corollary to identify the means to address the removal of such barriers. Increasing knowledge of these barriers is the first step in heightening awareness of this public health and medical problem.