Intimate Partner Violence: What Are Physicians' Perceptions?

Abstract

Background: Intimate partner violence (IPV) is common in primary care; 11% to 22% of women experienced physical abuse in the past year. Older women experience IPV as well, but it is often undetected. This study examined primary care providers' awareness about IPV in older women, including their screening practices and management.Methods: Interviews and focus groups were conducted with 44 primary care providers. Thematic analysis was used to identify common themes.Results: Providers fell along a continuum of thoroughness for identifying and managing IPV in older women, ranging from suboptimal to thorough identification of IPV and suboptimal to thorough management of the patient. In addition to the barriers commonly reported about IPV screening in younger women, providers described limited understanding of the diagnoses commonly associated with IPV, frustration with older women's unwillingness to disclose problems and ask for help, and limited community services that accommodate older women with IPV. Providers recommended that communities sponsor public awareness campaigns about IPV as a problem for all women and that aging and IPV agencies work together.Conclusions

Violência física e fatores associados: estudo de base populacional no sul do Brasil

“…In any case, the data corroborate fi ndings of other authors [8][9][10]21,22 according to whom providing care to the victims requires an adequate structuring of the health system in order to give the victims the proper attention in a dignifi ed way: to diagnose violence and meet the demand. In this fashion, the activities carried out by the Family Health Program and the Community Health Agents must be integrated.…”

“…In addition, prevalence rates are directly infl uenced by the known limitations of the reporting systems, which are sometimes diffi cult to compatibilize. 12,13,21 The fact that violence is not associated to living with a partner was not expected, seeing that domestic violence is object of much concern, and affects women mostly. 2,9,18 This result may be due to the methodology adopted (population-based), which enabled the study of different population segments, some of which did not live maritally, such as adolescents (13.4% of the sample).…”

“…However, this leads to refl ect on the extent to which the Brazilian health system and Brazilian professionals are prepared to identify and address the problem. In a qualitative study 21 it was found that many primary healthcare providers (doctors, nurses and assistants) fi nd it diffi cult to deal with the problem, stating that aspects related to the victim, lack of knowledge and adequate skills were the main obstacles. Taking this into account, we notice a positive perspective in the capacity building of these professionals, since education institutions are promoting courses for managers and health professionals aiming at fi lling this gap.…”

“…7 Age can also be related to violence: in Atlanta, in the United States, among women who had experienced some kind of physical violence throughout their lives, and who sought primary healthcare services, only 1% were older than 55 years of age. 21 In its most severe form, violence can lead to death. It is estimated that 40% to 70% of female homicides are committed by the closest male partner.…”

Assessment for Intimate Partner Violence: Where Do We Stand?

“…17 Physicians interviewed as part of a qualitative study attempting to explore these barriers did not believe that intimate partner violence was a medical issue or that finding solutions was within their scope of practice. 18 They said "we are not looking for new problems to screen for." 18 In this environment of reticence, medical students have been shown to have difficulty applying classroom-acquired knowledge of intimate partner violence in their clinical placements.…”