Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study

Abstract

BackgroundThirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women’s views and attitudes are regarding being asked about IPV.MethodsData were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data.ResultsThis study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV.ConclusionsIt is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study.

Towards understanding the Nordic paradox: A review of qualitative interview studies on intimate partner violence against women (IPVAW) in Sweden

“…These include women's experiences of violence (Almqvist & Broberg, ; Bergman, ; Bruno, ; Enander, , , , ; Eriksson & Ulmestig, ; Flinck, Paavilainen, & Astedt‐Kurki, ; Häggblom & Möller, ; Hydén, , , ; Jarnkvist & Brännström, ; Römpötti, ; Scheffer Lindgren & Renck, ), of violence during pregnancy (Edin, Dahlgren, Lalos, & Högberg, ; Edin & Högberg, ; Edin & Nilsson, ; Engnes & Lundgren, ; Finnbogadóttir, Dykes, & Wann‐Hansson, ) and motherhood (Almqvist & Broberg, ; Georgsson et al, ), and of leaving violent relationships (Enander, ; Enander & Holmberg, ; Häggblom & Möller, ; Holmberg & Enander, ; Hydén, , ; Hydén, ; Jarnkvist, ; Münger, ; Scheffer Lindgren & Renck, ). Studies have investigated women's experiences with the judicial (Agevall, ; BRÅ, ; Brännvall, ; Bruno, ; Ekström, ; Green, ; Jarnkvist, ; Jarnkvist & Brännström, ), social service (Eriksson & Ulmestig, ; Jarnkvist & Brännström, ; Nikupeteri, ; Ulmestig & Panican, ) and health care systems (Garnweidner‐Holme, Lukasse, Solheim, & Henriksen, ; Gillå et al, ; Häggblom & Möller, ; Leppakoski, Paavilainen, & Astedt‐Kurki, ; Mørk, Andersen, & Taket, ; Örmon & Hörberg, ; Örmon, Torstensson Levander, Sunnqvist, & Bahtsevani, ; Pratt‐Eriksson, Bergbom, & Lyckhage, ). The impact of IPVAW on the health (Örmon, Torstensson Levander, Sunnqvist, & Bahtsevani, ; Scheffer Lindgren & Renck, ), economy (Eriksson & Ulm...…”

“…Experiences and discourses of professionals working with the social services (Edin, Högberg, Dahlgren, & Lalos, 2009;Edin, Lalos, Högberg, & Dahlgren, 2008;Ekström, 2017Ekström, , 2018Helmersson, 2017;Keskinen, 2005;Kullberg, Skillmark, Nord, Pers, & Fäldt, 2015;Mattson, 2011Mattson, , 2013, police (Åkerström, 1998;BRÅ, 2000;Eriksson, 1995;Lundberg, 2001;Weinehall, 2011), prosecution service (Eriksson, 1995;Törnqvist, 2017;Weinehall, 2011), and health care (Finnbogadottir & Dykes, 2012;Gillå et al, 2018;Häggblom & Möller, 2008;Henriksen, Garnweidner-Holme, Thorsteinsen, & Lukasse, 2017;Hultmann, Möller, Ormhaug, & Broberg, 2014;Husso et al, 2012;Mørk et al, 2014;Socialstyrelsen, 2002;Stenson, Sidenvall, & Heimer, 2005;Sundborg, Törnkvist, Saleh-Stattin, Wändell, & Hylander, 2015) have been researched, as has the experience of teachers (Bruno, 2012) encountering violence against mothers. The perceptions of local-level decision makers and professionals on gender equality (Holmberg & Bender, 2003) and IPVAW prevention (Hensing, Von Borgenstede, Jakobsson, Krantz, & Spak, 2008;Jakobsson, von Borgstede, Krantz, & Hensing, 2013) have also been explored.…”

“…Within health care, despite overarching understandings of links between IPVAW and gender inequality, individually or socially oriented understandings of IPVAW have been observed among professionals (Bengtsson-Tops et al, 2009;Gillå et al, 2018;Henriksen et al, 2017;Husso et al, 2012;Mørk et al, 2014;Pratt-Eriksson et al, 2014;Socialstyrelsen, 2002;Sundborg et al, 2015), alongside tendencies to blame the victims for violence and for not leaving the relationship (Bengtsson-Tops et al, 2009;Leppakoski et al, 2011;Örmon et al, 2014a;Pratt-Eriksson et al, 2014). Among professionals working at schools, Bruno (2012) found an understanding of IPVAW as consisting of conflict between essentially equal parties, associated with socioeconomic vulnerability or foreign descent.…”

Describing the healthcare experiences and strategies of women survivors of violence

“…For example, Joyner and Mash (2014) reported that judgemental or directive counselling, based in beliefs that abused women were not active participants in their own health, was detrimental to providerpatient relationships and overall care. Women with and without experiences of IPV interviewed by Mork, Andersen, and Taket (2014) discussed the importance of respectful communication from providers. Further, an interview study with cancer survivors who had experienced CSA indicated that survivors wanted providers to address imbalanced power dynamics (Gesink & Nattel, 2015).…”

Women's experiences with healthcare professionals after suffering from gender‐based violence: An interview study

“…Sundborg, Tornkvist, Saleh‐Stattin, Wandell, and Hylander () suggested that the factors that facilitate nurses asking questions of women exposed to violence are having strategies for asking, knowing how to deal with the answers, and having a supportive environment (Sundborg et al., ). When asking about gender‐based violence, questions should be posed in an empathic, sensitive and nonjudgemental way (McCormack, Dewing, & McCance, ; Mørk, Andersen, & Taket, ).…”