Limitations of the Medical Model in the Care of Battered Women

Warshaw, Carole

doi:10.1177/089124389003004008

Cited by 107 publications

(70 citation statements)

References 19 publications

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“…However, most physicians lack the knowledge, skills and attitudes necessary to correctly identify and care for domestic violence victims. 2,[4][5][6][7] Several medical centers have developed domestic violence training programs for residents and students. 8 However, there have been few, if any, evaluations of the efficacy of domestic violence training on the subsequent behaviors and attitudes of trainees.…”

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confidence: 99%

Domestic violence training program for residents

et al. 1998

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Domestic violence is occurring in epidemic proportions in the United States. Recent surveys have shown there is a need for educational programs for health care professionals. This report presents the results of a domestic violence workshop developed to increase knowledge and improve attitudes and skills in working with victims of domestic violence. The results of the workshop, measured by preintervention and postintervention attitude, knowledge, and skills surveys, are promising. There was a significant improvement in knowledge, self-assessed skills, and attitudes after the workshop. Although the full magnitude of the changes was not sustained over time, there was still significant improvement after 6 months in knowledge and attitude. Rates of detection and documentation did not change. Future educational programs will need to address maintaining routine screening for domestic violence in the primary care setting and to highlight more clearly the role of health care professionals in the detection and treatment of domestic violence. A pproximately 4 million women in the United States are battered by their partners each year, resulting in 4,000 deaths. 1 It has been shown repeatedly that approximately one third of women seeking medical care in emergency departments are victims of domestic violence. 2 In primary care settings, 14% to 28% of female patients are domestic violence victims. 3 Recently, domestic violence has been more highly publicized, leading to an increased public awareness of this epidemic. However, most physicians lack the knowledge, skills and attitudes necessary to correctly identify and care for domestic violence victims. 2,4-7 Several medical centers have developed domestic violence training programs for residents and students. 8 However, there have been few, if any, evaluations of the efficacy of domestic violence training on the subsequent behaviors and attitudes of trainees. 9 In this study, we evaluated the impact of a 4-hour domestic violence training workshop on knowledge, behavior, and attitudes of medical residents. We hypothesized that the educational intervention would significantly increase residents' knowledge, skills, and attitudes and increase the number of patients screened, detected, and documented in medical records. METHODSFifty-five residents participated in this study; 34 (62%) were male and 21 (38%) were female. All were residents in the 3-year Medical College of Pennsylvania Internal Medicine Residency of the Allegheny University of the Health Sciences. Each resident was required to attend one domestic violence workshop. Five identical workshops were held over a 2-week period, each replacing one continuity clinic session. The InterventionThe 4-hour workshop included the following: Surveys. Participants filled out a Doepel Domestic ViolenceSurvey, 10 before and after the workshop. This survey measured residents' knowledge, attitudes and self-assessed skills. The survey consists of multiple-choice questions, true/false questions, and attitude items that require a response on...

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Domestic violence training program for residents

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“…En 1981, Stark et al estimaient cette proportion à moins d'une femme violentée sur 25, et la situation ne semble pas avoir beaucoup changé depuis (Warshaw, 1989).…”

Section: Non-spécificité Des Signes Liés à La Violence Conjugaleunclassified

“…Comme le soulignait MacLeod en 1980, les médecins sont formés pour traiter les symptômes et non les expériences de vie de leurs patientes. Une recherche de Warshaw (1989) met en évidence que, même lorsqu'il est clair qu'une femme a été blessée par son partenaire, les professionnels de la santé qui la reçoivent en salle d'urgence lui posent rarement des questions directes sur cette agression. La grande majorité (90 %) des médecins de l'échantillon de Warshaw n'ont posé aucune question sur l'histoire psychosociale des femmes rencontrées.…”

Section: Hésitations à Interroger Les Femmes Sur La Violence Conjugaleunclassified

“…Dans 78 % des cas, les médecins n'ont pas tenté de définir la relation qu'il y avait entre la victime et l'agresseur. Warshaw (1989) conclut qu'en ne posant pas ce genre de questions, la ou le médecin ne rate pas seulement l'occasion d'identifier la violence lorsque celle-ci n'est pas vraiment claire, mais il ne peut non plus s'engager dans aucune mesure préventive, ni protéger la femme dont la vie peut être en danger.…”

Section: Hésitations à Interroger Les Femmes Sur La Violence Conjugaleunclassified

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Dépistage systématique de la violence conjugale. Réflexion théorique et développement d’un protocole

Rinfret-Raynor

Turgeon

2005

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À la suite d'une démarche de planification socio sanitaire visant à définir les priorités d'action pour les années à venir, la violence conjugale est devenue une des deux problématiques prioritaires pour le CLSC Saint-Hubert et son dépistage, un objectif important du plan opérationnel. Pour atteindre cet objectif, le CLSC a fait appel au Centre de recherche interdisciplinaire sur la violence familiale et la violence faite aux femmes (CRI-VIFF). Une équipe de recherche de ce centre a travaillé à l'élaboration d'un protocole de dépistage systématique de la violence conjugale. Cet article d écrit l'élaboration de ce protocole et son application par un nombre limité d'intervenants et d'intervenantes auprès d'une partie de la clientèle du CLSC. Cette phase expérimentale précède l'application généralisée du protocole dans tous les services du CLSC.The issue of marital violence was chosen as one of two priorities by the CLSC Saint-Hubert staff and board following a broad-based community planning effort which was to guide actions for the coming years. Identifying women suffering from their husband's violent behavior became a primary goal. In order to achieve this goal, researcher's assistance was enlisted. Members of the Centre de recherche interdisciplinaire sur la violence familiale et la violence faite aux femmes (CRI-VIFF) developed a structured protocol to screen systematically adult female clients for spousal violence. This paper describes the development of the screening tool and its preexperimental utilization by several types of health and mental health professionals serving a segment of the CLSC Saint-Hubert population. This exploratory phase takes place prior to the generalization of the screening tool use to the CLSC entire service delivery System. Nous tenons à remercier Mme Nathalie Beauregard pour sa participation à la traduction du résumé

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“…This criticism is based largely on studies that reveal that only the most serious cases of physical violence are recognized by physicians, while the social and emotional aspects are virtually ignored (Stark, Flitcraft, & Frazier, 1979;Kurz & Stark, 1988;Warshaw, 1993;Varcoe, 1997). When violence is detected, studies show that women often feel that they have been treated in an insensitive and even hostile manner (Yam, 2000;McCauley, Yurk, Jenckes, & Ford, 1998;Varcoe, 1997).…”

Section: Statement Of the Problemmentioning

confidence: 99%

Letting the light in : universal screening for woman abuse in a northern health care setting

Hunter¹

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Given that substantial numbers of abused women seek health care services and given the negative impact abuse has on women, children and communities at large, the health care sector has a vital role to play in addressing violence against women. However, due to a combination of personal, institutional and ideological factors, the needs of abused women are often overlooked in the health care encounter. This is troubling because the hospital emergency room represents a significant point of entry for abused women to receive treatment, support and safety. For those living in northern, rural and remote communities, the hospital may be the only source of assistance available to women experiencing violence. This case study critically explores the implications of adopting a health care policy known as "universal screening" for use in a northern, rural or remote health care setting. It is argued that with appropriate training and education, health care providers can use the screening process to go beyond simply inquiring about abuse and treating the physical symptoms to paving the way to women's empowerment.The main goals of screening from an empowerment perspective are listening with empathy; providing support and validation; offering appropriate treatment, information and referrals; and reassuring women that the violence is not their fault. Most notably, this project asserts that developing a critical consciousness about the complex interplay between the personal, social and political aspects of woman abuse is a necessary component of empowerment practice. With this knowledge, rather than feeling that they need to fix the problem, health care providers will recognize that women are the best judges of their own circumstances. Abstract

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Limitations of the Medical Model in the Care of Battered Women

Cited by 107 publications

References 19 publications

Domestic violence training program for residents

Domestic violence training program for residents

Dépistage systématique de la violence conjugale. Réflexion théorique et développement d’un protocole

Letting the light in : universal screening for woman abuse in a northern health care setting

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