Orthopaedic Surgeons’ Knowledge and Misconceptions in the Identification of Intimate Partner Violence Against Women

Abstract

Background Intimate partner violence (IPV)-physical, sexual, psychologic, or financial abuse between intimate partners-is the most common cause of nonfatal injury to women in North America. As many IPV-related injuries are musculoskeletal, orthopaedic surgeons are well positioned to identify and assist these patients. However, data are lacking regarding surgeons' knowledge of the prevalence of IPV in orthopaedic practices, surgeons' screening and management methods, and surgeons' perceptions about IPV. Questions/purposes We aimed to identify (1) surgeon attitudes and beliefs regarding victims of IPV and batterers and (2) perceptions of surgeons regarding their role in identifying and assisting victims of IPV. Methods We surveyed 690 surgeon members of the Orthopaedic Trauma Association. The survey had three sections: (1) general perception of orthopaedic surgeons regarding IPV; (2) perceptions of orthopaedic surgeons regarding victims and batterers; and (3) orthopaedic relevance of IPV. One hundred fifty-three surgeons responded (22%). Results Respondents manifested key misconceptions: (1) victims must be getting something out of the abusive relationships (16%); (2) some women have personalities that cause the abuse (20%); and (3) the battering would stop if the batterer quit abusing alcohol (40%). In the past year, approximately 1 . 2 the respondents (51%) acknowledged identifying a victim of IPV; however, only 4% of respondents currently screen injured female patients for IPV. Surgeons expressed concerns regarding lack of knowledge in the management of abused women (30%). Conclusion Orthopaedic surgeons had several misconceptions about victims of IPV and batterers. Targeted educational programs on IPV are needed for surgeons routinely caring for injured women.

Beliefs about intimate partner violence: A survey of the Swedish general public

“…These perceptions correspond fairly well with national and international reports of IPV incidence rates (see e.g., Black et al ., ; Nybergh et al ., ). Compared with previous findings, where the general public overestimated (see e.g., Beeble et al ., ) and healthcare providers underestimated (see e.g., Della Rocca et al ., ) IPV prevalence, the estimates in the present sample were more in line with recent prevalence statistics. It is possible that public awareness and education campaigns in recent years have made the Swedish population relatively knowledgeable about IPV prevalence.…”

“…Our findings on respondents’ victim‐blaming attitudes suggest that people tend to overlook the complexity that victims face when weighting the pros and cons of staying in an abusive relationship, consistent with previous reports in the literature (Anderson & Saunders, ; Baly, ; Gracia, ; Meyer, ; Waltermaurer, ; Yoshihama, ). In line with victim blame research (see e.g., Bhandari et al ., ; Della Rocca et al ., ; Sprague et al ., ; West & Wandrei, ; Worden & Carlson, ), our respondents believed that IPV victims are to some degree responsible for the violence and able to put an end to the abuse. Such blameful responses, when expressed to victims, can increase victims’ self‐blame and negatively affect the likelihood of them acting proactively against the abuse (Flood & Pease, ).…”

“…Despite the existence of policies and screening tools, healthcare personnel tend to underreport cases of IPV (Webster, Pedrosa & Lopez, ). This is consistent with surveys showing that healthcare providers make low estimates of IPV prevalence among their female patients (≤ 1% in Bhandari, Sprague, Tornetta et al ., ; Sugg, Thompson, Thompson, Maiuro & Rivara, ; ≤5% in Della Rocca, Sprague, Dosanjh, Schemitsch & Bhandari, ).…”

“…Consistent with such attributions, research has documented the common belief that victims of IPV could easily end a destructive relationship; since they “choose” to stay in the relationship, they must either want to be abused (Sprague, Kaloty, Madden, Dosanjh, Mathews & Bhandari, ) or at least have accepted the violence (Worden & Carlson, ). Other research findings indicate that people partly attribute causal responsibility to IPV victims, believing, for instance, that victims have provocative personality features (Bhandari et al ., ; Della Rocca et al ., ; Gracia & Tómas, ; West & Wandrei, ) or provoke violence through irrational or irresponsible behavior (Anderson & Saunders, ). Shifting accountability for the violence from the perpetrator and onto the victim is an expression of people seeking justifications for the violence.…”

Intimate partner violence and Musculoskeletal injury: bridging the knowledge gap in Orthopaedic fracture clinics

“…These findings were supported by a similar evaluation of US surgeon members of the Orthopaedic Trauma Association which found that among 153 surgeon members of the Orthopaedic Trauma Association, several misconceptions were evident: 1) victims must be getting something out of the abusive relationships (16%); 2) some women have personalities that cause the abuse (20%); and 3) the battering would stop if the batterer quit abusing alcohol (40%). In the past year, only 4% of respondents currently screened for IPV among female patients with injuries [9]. …”