Experiences of Battered Women in Health Care Settings: A Qualitative Study

Abstract

Interventions to help battered women seek and receive optimal health care must be informed by battered women's experiences in health care settings. In this study, we used a Systems Model to categorize the barriers battered women encounter in health care settings into patient, provider, and organizational levels. We conducted in-depth, face-to-face interviews with 31 battered women recruited by random digit dialing of households and by a publicity recruitment campaign. The data revealed that at the patient level, many women chose to conceal their abuse from their health care professionals, some fearing retaliation from their partners if they revealed the source of their injuries. At the provider level, the women perceived health care professionals to be disinterested or unsympathetic toward the needs of battered women, causing the women to feel ignored or trivialized. And at an organizational level, battered women believed that the structure of the health care system did not allow health care professionals enough time to deal with issues beyond treating their immediate presenting injuries. To ensure that battered women seek and receive optimal health care, multicomponent interventions should be designed to address the complex barriers at the three levels. We conclude by suggesting possible ways to help battered women get the tools they need to raise the issue of domestic violence with their health care professional. We also suggest ways to enable these professionals to identify battered women, validate their experiences, and provide appropriate referrals.

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

“…In the descriptive analysis, frequency distributions of study variables were examined and the prevalence of psychological and physical violence was determined. 2 tests were used to assess the associations of demographic variables with types of violence. Race (white versus nonwhite), education, marital status, and depression were then entered into a logistic regression model to determine which demographic factors independently predicted physical and psychological violence.…”

“…1 These effects include injury, reproductive health consequences, mental health problems, family problems, and high rates of health care utilization. [2][3][4] Mounting research suggests that many abused victims seek health care for injuries and other health problems related to abuse. Health care costs have been found to be higher in women who report partner violence.…”

Integrating Intimate Partner Violence Assessment and Intervention into Healthcare in the United States: A Systems Approach

“…When risk or exposure to past or current IPV is assessed through such inquiry, the impact of the encounter can be primary prevention for patients with no history of exposure, secondary prevention for patients with past exposure, or tertiary prevention (i.e., early intervention) for patients with current or acute exposure. 11,[50][51][52] The health professional and patient interface IPV may be identified in the clinical setting because either the patient or a third party, such as police or emergency medical services (EMS) personnel, discloses IPV or because the health professional inquires about past or current exposure ( Fig. 1).…”

Screening for Domestic Violence in Public Welfare Offices

“…For women engaged in the "dance of disclosure" (Gerbert et al, 1996) related to domestic violence, it may take several screening attempts on the part of the professional before a woman is able to discuss her situation openly. When organizational practices limit discussion of domestic violence to intake interviews, or to single questions within those interviews, many women who are in need of services are likely to be missed.…”