Making sense of domestic violence intervention in professional health care

Abstract

What is known about this topic dSocial and health care organisations have often been reluctant to recognise domestic violence and to intervene. Social and health care professionals are in a key position to identify and intervene in domestic violence. What this paper adds dThe article illuminates current ways of making sense of domestic violence interventions by health care professionals. Developing successful practices requires a broad understanding of the effects of domestic violence and the challenges it presents to health care professionals. Support and establishing practices at the organisational level are the key elements in building a responsible approach to domestic violence. AbstractIntervening in domestic violence in the health care and social service settings is a complex and contested issue. In this qualitative, multidisciplinary study, the barriers to but also the possibilities for health care professionals in encountering victims of violence were scrutinised. The focus was on omissions in service structure and practices. The data consisted of six focus group interviews with nurses, physicians, social workers and psychologists in specialist health care (n = 30) conducted in Finland in 2009. The aim was to explore professionals' processes of making sense of violence interventions and the organisational practices of violence interventions. Four types of framing of the domestic violence issue were identified: (i) practical frame, (ii) medical frame, (iii) individualistic frame and (iv) psychological frame. Each frame consisted of particular features relating to explaining, structuring or dismissing the question of domestic violence in health care settings. The main themes included the division of responsibilities and feasibility of treatment. All four frames underlie the tendency for healthcare professionals to arrive at sense-making practices where it is possible to focus on fixing the injuries and consequences of domestic violence and bypassing the issue of violence as the cause of symptoms and injuries. The results indicate that developing successful practices both in identifying survivors of domestic violence and in preventing further victimisation requires a broad understanding of the effects of domestic violence and the challenges for health care professionals in dealing with it. New perspectives are needed in creating adequate practices both for victims of violence seeking help and for professionals working with this issue. Strong support at the organisational level and established practices throughout the fields of health and social care are the key elements in building a responsible approach to domestic violence.

Developing Better Services for Intimate Partner Violence: Hearing the Voice of Disabled People

“…Professionals do not necessarily have information about local IPV services, which limits making appropriate referrals. Neither were there clear care pathways in organizations [23].…”

“…There are various reasons behind thisfinding. As can be seen from the multi-disciplinary frame analysis by Husso and her colleagues [23], limited skills in recognizing and in asking about IPV were reported. Social and health care staff found the issue very important, but for them, it was the task and duty of "someone else".…”

“…A large public-sector project called VISH aimed at developing IPV interventions in specialist health care from 2009-2010; however, practices varied widely across municipalities or health or social care units [23]. Besides public services, the third sector provides IPV services in Finland, but there are no research reports regarding this kind of collaboration.…”

“…Experiences of earlier development work (e.g. the VISH intervention in special heath care, see [23]) were utilized. Work was carried out in an area of Southern Savo in Finland.…”

Identifying signs of intimate partner violence

“…Further, this lack of knowledge about IPV and its effects can lead to feelings of inadequacy and frustration, which adds to the barriers (Husso et al, 2012). To be able to effectively identify and respond to victims of IPV nurses need to understand the problem and its associated complexities.…”