Physician Interaction With Battered Women: The Women's Perspective

Hamberger, L. Kevin; PhD, Brace Ambuel; Marbella, Anne; Donzé, Jacques

doi:10.1001/archfami.7.6.575

Cited by 99 publications

(68 citation statements)

References 16 publications

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“…54 Although our participants did not ask for safety planning, in a study that surveyed 115 IPV victims who had sought help from IPV agencies, 25% reported safety planning done by a physician and considered it a desirable behavior. 55 Physicians might *Warning symptoms and conditions: injuries (ask about the mechanism of the inquiry, if mechanism does not make sense, consider probing further in a nonjudgmental manner); chronic pain (headache, abdominal pain, including irritable bowel syndrome, pelvic pain, back pain, etc); vague somatic complaints (fatigue, dizziness); mental health issues (depression, anxiety, post-traumatic stress disorder, substance abuse); abuser's inappropriate behavior in the offi ce. 5-12 † Safety assessment: evaluate suicide oe homicide risk (victim and abuser), weapons or threat to use weapons (victim and abuser), drug and alcohol use (victim and abuser), abuse of children, abuse of pets, escalating severity of abuse, threats to life.…”

Section: Intimate Partner Violence Victim Managementmentioning

confidence: 99%

Medical Management of Intimate Partner Violence Considering the Stages of Change: Precontemplation and Contemplation

Zink

Elder

Jacobson

et al. 2004

The Annals of Family Medicine

130

114

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BACKGROUND We undertook a study to understand how women who are victims of intimate partner violence (IPV) want physicians to manage these abusive relationships in the primary care offi ce.METHODS Thirty-two mothers in IPV shelters or support groups in southwestern Ohio were interviewed to explore their abuse experiences and health care encounters retrospectively. The interviews were taped and transcribed. Using thematic analysis techniques, transcripts were read for indications of the stages of change and for participants' desires concerning appropriate physician management.RESULTS Participants believed that physicians should screen women for IPV both on a routine basis and when symptoms indicating possible abuse are present, even if the victim does not disclose the abuse. Screening is an important tool to capture those women early in the process of victimization. When a victim does not recognize her relationship as abusive, participants recommended that physicians raise the issue by asking, but they also warned that doing more may alienate the victim. Participants also encouraged physicians to explore clues that victims might give about the abuse. In later contemplation, victims are willing to disclose the abuse and are exploring options. Physicians were encouraged to affi rm the abuse, know local resources for IPV victims, make appropriate referrals, educate victims about how the abuse affects their health, and document the abuse. Participants identifi ed a variety of internal and external factors that had affected their processes. CONCLUSIONSIn hindsight, IPV victims recommended desired actions from physicians that could help them during early stages of coming to terms with their abusive relationships. Stage-matched interventions may help physicians manage IPV more effectively and avoid overloading the victim with information for which she is not ready. BACKGROUNDI n the primary care offi ce, 11% to 22% of women are currently experiencing physical abuse. [1][2][3] Studies show that intimate partner violence or abuse (IPV) affects the physical and mental health of victims [4][5][6][7][8][9][10][11][12] and of children who witness it. [13][14][15][16][17][18] Because IPV is commonplace and the consequences of IPV are serious, professional organizations recommend that physicians routinely screen the woman alone without her spouse or children. [19][20][21][22][23] The value of screening for IPV when effectiveness has not been proved remains subject to controversy. 24,25 Rhodes and Levinson 26 remind us, however, that physicians will continue to see both men and women who are abused and that the recognition of abuse may infl uence the evaluation of the patient' s complaints as well as the outcomes of care.Studies show that physicians are not screening. [27][28][29] The reported barriers One barrier not mentioned in the literature is that children are often with their mothers in the offi ce. Sometimes children accompany their mothers to her medical appointments (8%), and often mothers bring children to ...

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Section: Intimate Partner Violence Victim Managementmentioning

confidence: 99%

Medical Management of Intimate Partner Violence Considering the Stages of Change: Precontemplation and Contemplation

Zink

Elder

Jacobson

et al. 2004

The Annals of Family Medicine

130

114

View full text Add to dashboard Cite

show abstract

“…[7][8][9] Many have called for using a single question designed to detect intimate partner violence embedded within general health behavior surveys. 10 -12 "Safety" questions (eg, "Do you feel safe at home?…”

mentioning

confidence: 99%

Screening for Intimate Partner Violence in a Primary Care Setting: The Validity of "Feeling Safe at Home" and Prevalence Results

Peralta

Fleming

2003

The Journal of the American Board of Family Medicine

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Background: We conducted a study to assess the validity of a screening question commonly used to detect intimate partner violence (IPV) in primary care settings. We also analyzed prevalence and risk factors of IPV.Methods: We used an embedded domestic violence detection instrument in a general health questionnaire at one family medicine clinic. Questionnaire scales included a modified version of the Conflict Tactics Scale (CTS), depression and alcohol use scales, and a personal safety question ("Do you feel safe at home?"). We assessed the sensitivity, specificity, and predictive value of the personal safety question in our sample using responses to the modified CTS and the personal safety question. Three hundred ninety-nine female patients over the age of 18 completed the survey.

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“…Следи препрека да се жртве стиде и боје не-разумевања околине (61,0%). Наши резултати су исти као у сличним студијама 23,25,26 . Да је препрека то што се жене враћају у исто окружење сматра 53,7% испитаника, ста-тистички значајно више лекара (р=0,039), у британској студији 11% 15 .…”

Section: препреке у вези са самим жртвама насиљаunclassified

“…У великом броју студија је утврђено да већина жр-тава нема ништа против тога да буду питане о насиљу Снежана Б. Кнежевић и сар. Препреке код здравствених радника за откривање више жена жртава насиља у породици Општа медицина 2017;23(3-4):67-77 и очекују од здравствених радника да буду активнији у постављању питања, што није случај са ставом наших испитаника 25,26,30,31 . Током свакодневног рада, здравстве-ни радници треба да искористе терапеутски потенцијал и препознају насиље, да га јасно осуде, да осећају и по-казују емпатију према жртви током разговора, да пону-де континуитет у пружању здравствене заштите, да буду свесни тога да није њихов задатак решавање тог пробле-ма, већ вештина да упуте на надлежне институције 1,6,7,32 .…”

Section: препреке у вези са самим жртвама насиљаunclassified

Barriers to health care professionals in detecting more domestic violence

Knežević¹,

Gajović²,

Marinkovic³

2017

Opsta med

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СажетакУвод. Женама које пролазе кроз здравствени систем се не препознаје довољно често насиље које трпе у породици.Циљ рада. Утврдити препреке међу здравственим радницима због којих се не утврђује више случајева насиља над женама.Метод. Упитник који је подељен здравственим радницима Дома здравља у Краљеву, и послат на њихове имејл адресе.Резултати. Обухваћено је 136 здравствених радника, 73,3% женског и 26,7% мушког пола; 70,6% лекара и 29,4% техничара. Највећи број испита-ника је старости од 31 до 50 година, просечно 38,93±7,7; просечна дужина радног стажа 11,36±7,74 година. Социјалне препреке су статистички значај-но више заступљене код жена (р=0,037). Највише одговора има недостатак смерница за поступање, са статистичком значајности према стручној спре-ми, р=0,002. Међу институционалним препрекама истиче се преоптереће-ност послом (53,7%), неинформисаност о процедурама, статистички зна-чајно код лекара (р=0,003), затим страх за сопствену безбедност (46,3%). Препреке повезане са самим здравственим радницима имају најмање одго-вора (24,7%). Истиче се ограниченост временом; статистички значајно пре-ма полу (р=0,002) и квалификацијама (р=0,009) постоји недостатак знања, следи недостатак тренинга (44,9%). Жене очекују већа овлашћења у раду, р=0,035. Међу четири групе препрека, највише одговора је у вези са самим жртвама насиља (43,9%), статистички значајно више код лекара (р=0,004), највише да жртве крију насилно понашање партнера (65,4%).Закључак. Омогућити стално образовање о насиљу у породици и про-цењивање знања, ослободити жртве насиља да имају поверење у здравствени систем, подизати свест о осуди насиља, вешто упућивати жене на одгова-рајуће институције у заједници које би им могле пружити помоћ. Кључне речи:примарна здравствена заштита, здравствени радници, општа медицина, насиље у породици, решавање проблема

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Physician Interaction With Battered Women: The Women's Perspective

Abstract: We identified discrete sets of desirable and undesirable physician behaviors. Further research is needed to clarify racial differences found in this study. Findings can help guide both clinical practice and the development of physician training curricula.

Cited by 99 publications

References 16 publications

Medical Management of Intimate Partner Violence Considering the Stages of Change: Precontemplation and Contemplation

Medical Management of Intimate Partner Violence Considering the Stages of Change: Precontemplation and Contemplation

Screening for Intimate Partner Violence in a Primary Care Setting: The Validity of "Feeling Safe at Home" and Prevalence Results

Barriers to health care professionals in detecting more domestic violence

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