Factors that facilitate recognition and management of domestic violence by primary care physicians in a Chinese context - a mixed methods study in Hong Kong

Abstract

Background Domestic violence is common in the community. Many of its victims present to primary care physicians (PCPs) but are not being recognized and managed. The barriers, with specific reference to a Chinese cultural context, were investigated earlier. This paper explored the factors which facilitated the process of recognizing and managing suspected cases of domestic violence by PCPs in Hong Kong. Methods Four focus group interviews were conducted to explore in-depth the experiences of PCPs in recognition, management and referral of domestic violence cases from which facilitators were identified. The relevant themes were then investigated in a questionnaire survey with 504 PCPs working in public and private sectors. Results The focus group participants emphasized mood symptoms as useful indicators for probable abuse and continuity of care was important to unmask issues of domestic violence. The top facilitators perceived by the respondents of the survey included: a trusting doctor-patient relationship (99.8%), good communication skills (99.0%), patients’ unexplained bruises (96.3%), medical history (94.6%), and mood symptoms (94.4%). Further, the survey found that PCPs with longer years of practice, a medical degree obtained from Western countries, and postgraduate training in family counselling or psychological medicine perceived more facilitators in managing domestic violence. Conclusions Without a local screening policy and training protocol to manage domestic violence, PCPs regarded their skills in mental healthcare and good relationships with patients as the key facilitators. While training in mental health care helps PCPs manage domestic violence, a specific protocol emphasizing medical-social collaboration is anticipated to facilitate them to take a more proactive and effective stance from screening to management.

Perceptions of primary health care workers regarding violence against women

“…This study’s results are similar to the results reported by a study conducted in Japan, according to which recognizing women as victims of violence is usually easier when it involves physical signs and interventions are essentially based on the curative model ( 15 ) . In addition, the authors note that for workers to deal with these situations, communication and continuity of care are essential so that these situations can be identified and prevented at the beginning, avoiding it from getting worse.…”

Exploration of barriers to screening for domestic violence in the perinatal period using an ecological framework

“…Hegarty, Spangaro, et al (2020), also reported that healthcare providers wanted clear processes for screening women for domestic violence. Similar findings were concluded in a mixed method study with primary healthcare physicians in Hong Kong (Lam et al, 2020); and a questionnaire of Royal College of Physicians and Surgeons in Canada (Long et al, 2019). The perinatal period is an opportune time to screen for domestic violence due to this being a high contact period for women with their primary‐based healthcare providers (Campo, 2015), therefore, more focus on supporting healthcare providers with tangible screening tools and protocols is recommended.…”

The Perceptions and Attitudes on Domestic Violence of the Social Network Members in Northeastern Thailand

“…Village health volunteers use non-fixed criteria to assess household abuse risk, making it difficult to determine if domestic violence will be prioritized on the community agenda. Effective communication and interpretation are essential for the network's perception mechanism (Lam et al, 2020).…”