The Emergency Department Response to Women Experiencing Intimate Partner Violence: Insights From Interviews With Clinicians in Australia

Abstract

Background and Objectives: Emergency departments (EDs) are essential providers of compassionate, immediate treatment and referral for women experiencing intimate partner violence (IPV). IPV, largely perpetrated by men against women, exerts a substantial burden on the health systems and economies of all nations. There is little known about how staff in Australian EDs respond to the challenges such violence generates. We therefore examined the clinical team response to women experiencing IPV in two large Australian metropolitan hospital EDs.Methods: We undertook qualitative semistructured interviews and focus group discussions with 35 social workers, nurses, and doctors. Transcripts were recorded and transcribed verbatim. We analyzed the data thematically. We first undertook line-by-line coding and organized content into descriptive categories. Latent and manifest patterns were identified across the data and mapped to key themes in negotiation with all authors.Results: Respondents emphasized challenges identifying IPV resulting from professional uncertainty or discomfort and women's fear of the ramifications of disclosure. Emergency clinicians routinely referred women to social workers after medical treatment and described effective collaboration across professions. Social workers outlined difficulties coordinating care with health and community agencies. Staff highlighted challenges maintaining nonjudgmental attitudes and managing their own feelings-especially clinicians who had personally experienced violence.Conclusions: Emergency departments can provide caring environments for women experiencing IPV. Effective interprofessional teamwork across nursing, medical, and social work professionals may mitigate the need for formal screening tools. Supportive workforce environments can improve staff understanding, reduce stigma, enhance appropriate treatment, and counsel health professionals experiencing violence. However, staff training and advocacy and referral relationships with local programs require strengthening. A connected multisystemslevel response is required to coordinate and resource services for all affected by violence. I ntimate partner violence (IPV) is a significant public health issue in high income countries with an overall 12-month period prevalence of 4%. 1 IPV is largely perpetrated by men against women and is therefore a key determinant of women's and children's health that exerts a substantial burden on the health systems and

Sexist Myths Emergency Healthcare Professionals and Factors Associated with the Detection of Intimate Partner Violence in Women

“…This study is a cross-sectional study by means of a voluntary, anonymous survey self-completed in paper by healthcare professionals from three emergency departments of urban reference public health hospitals (two specialty centres and one trauma centre) in the capital city of Granada (Spain). Physicians and nurses were invited to participate, since they are usually the first people outside the family environment to whom women are directed and are the professional categories most likely to assist them in the course of their activity and, therefore, to detect IPV cases, thus forming a sufficiently homogeneous group to obtain consistent results, as previously done [ 35 , 55 , 56 , 57 ]. With a total number of 195 professionals, with 90% power and 5% accuracy, a sample size representing 128 participants was estimated.…”

“…Among healthcare providers, most studies are focused on identifying their attitudes, beliefs, and perceptions on detection and response to IPV. Insufficient training, a lack of skills in handling such cases, fear of legal implications, resistance due to own values or to the professional role performed, weak scientific evidence on the effectiveness of interventions, frustration, and not being able to stop abuse are signalled as some of the individual factors that have an influence on the approach to this problem [ 15 , 16 , 17 , 29 , 35 ].…”

“…It has even been reported that many women who are murdered by their partners/former partners had resorted to emergency services [31]. That is why they constitute a privileged attention unit, not only to treat any possible injuries, but also to actually help victims minimise their exposure to abuse, or even to get out of such situation [15,35]. However, the efficacy of emergency services in the detection of IPV cases, particularly during the current health crisis, and of the factors associated with detection by healthcare professionals, including opinions on sexist myths, requires further research [53,54].…”

Emergency department nurses experiences of female domestic violence presentations: A review of the qualitative literature

“…For example, time constraints, privacy issues, unease about asking the "question" and incorrect or inappropriate assumptions. [19][20][21] However, there is evidence from the literature that ED nurses often feel ill-prepared, are fearful of causing offence or uncomfortable in asking appropriate questions that would positively identify DV presentations. 18,22,23 Therefore, the focus of this review is to explore ED nurses experiences of women who present to the ED after being subjected to DV.…”

Lessons Learned – Beobachtungsstudie nach einem Jahr Sprechstunde «Häusliche Gewalt» am Universitären Notfallzentrum Bern

“…Bekannt ist, dass Mediziner_innen vor allem mit fehlender Zeit [6,15] sowie Problemen beim Ansprechen und Erken nen von HG [5] konfrontiert sind, weshalb eine enge Zu sammenarbeit mit weiterbetreuenden Stellen (z.B. Sozial diensten) zu empfehlen ist [16].…”