Personal barriers to addressing intimate partner abuse: a qualitative meta-synthesis of healthcare practitioners’ experiences

Tarzia, Laura; Cameron, Jacqui; Watson, Jolanta A.; Fiolet, Renee; Baloch, Surriya; Robertson, Rebecca; Kyei-Onanjiri, Minerva; McKibbin, Gemma; Hegarty, Kelsey

doi:10.1186/s12913-021-06582-2

Cited by 28 publications

(28 citation statements)

References 57 publications

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“…Studies exploring the perceptions of HCPs consistently indicate that this fear is a very real barrier to enquiry and response. 15 Given that a range of clinical conditions may be caused or complicated by IPA, including chronic pain, suicidal ideation, gynaecological issues, depression and addiction, asking about patient exposure is highly relevant to the medical encounter and the provision of appropriate healthcare support. 1 6 10 Children also experience detrimental effects from IPA exposure, and studies indicate that children are a significant factor in women’s decisions to seek professional support.…”

Section: Discussionmentioning

confidence: 99%

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Women’s experiences and expectations of intimate partner abuse identification in healthcare settings: a qualitative evidence synthesis

et al. 2022

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ObjectivesTo explore women’s experiences and expectations of intimate partner abuse (IPA) disclosure and identification in healthcare settings, focusing on the process of disclosure/identification rather than the healthcare responses that come afterwards.DesignSystematic review and meta-synthesis of qualitative studiesData sourcesRelevant studies were sourced by using keywords to search the databases MEDLINE, EMBASE, CINAHL, PsychINFO, SocINDEX and ASSIA in September 2021.Eligibility criteriaStudies needed to focus on women’s views about IPA disclosure and identification in healthcare settings, use qualitative methods and have been published in the last 5 years.Data extraction and synthesisRelevant data were extracted into a customised template. The Critical Appraisal Skills Programme checklist for qualitative research was used to assess the methodological quality of included studies. A thematic synthesis approach was applied to the data, and confidence in the findings was appraised using The Confidence in the Evidence from Reviews of Qualitative research methods.ResultsThirty-four studies were included from a range of healthcare settings and countries. Three key themes were generated through analysing their data: (1) Provide universal education, (2) Create a safe and supportive environment for disclosure and (3) It is about how you ask. Included papers were rated overall as being of moderate quality, and moderate-high confidence was placed in the review findings.ConclusionsWomen in the included studies articulated a desire to routinely receive information about IPA, lending support to a universal education approach that equips all women with an understanding of IPA and options for assistance, regardless of disclosure. Women’s suggestions for how to promote an environment conducive to disclosure and how to enquire about IPA have clear implications for clinical practice.PROSPERO registration numberCRD42018091523.

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Section: Discussionmentioning

confidence: 99%

“… 15 16 These include a reluctance to interfere in a patient’s ‘private’ issues, frustration and feelings of helplessness when patients do not take their advice, and resistance to taking responsibility for dealing with IPA. 15 …”

Section: Introductionmentioning

confidence: 99%

Women’s experiences and expectations of intimate partner abuse identification in healthcare settings: a qualitative evidence synthesis

et al. 2022

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“…[ 50 51 ] Even in European countries family physicians and health care workers reported the hurdles in addressing such abusive events. [ 52 ] The need to develop policies and awareness campaign to know own rights and being assertive to report abusive incidents are inevitable.…”

Section: Methodsmentioning

confidence: 99%

He hit me; but it’s okay! Female submissiveness in marital abuse: A review in Indian context

Kumar¹,

Stephen²,

George³

et al. 2022

Journal of Family Medicine and Primary Care

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India, a country with manifold multicultural bonds and relationships often witnesses a gross number of conflicted marital relationships. The plight in the frequency of marital abuse reporting in India has called gross public health attention globally. Multiple factors contribute to this arena in which, when we analyse can find out females submissiveness to report and or react to such kind of abusive incidences. The objective of this article is to review recent literature on female submissiveness in marital abuse. This narrative review is carried out to depict various perspectives that initiate abusive relationships and certain factors that prevent women from being subjected to rapid response. Literature relevant to the topic which was published within twenty years in prominent journals, newspapers, and websites has been reviewed thoroughly while writing this paper. Keywords for literature search included terms such as domestic violence, intimate partner violence/abuse, spouse abuse, married woman/female submissiveness, abusive marital relationships, and marital abuse. There is a paucity of studies analysing psychological and socio-demographic determinants of this submissiveness within such relationships in India. Several factors such as cultural, psycho-social, environmental attributes may prompt submissiveness among females in abusive marital relationships, which often leads to psychopathology and physical ailments. It is important to understand the need for a multidisciplinary approach to preventing marital abuse as a public health issue. By preventing and modulating such factors public health and women’s well-being can be preserved in various domains.

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“…There are many barriers to inquiry by health practitioners and disclosure by victims/survivors 19‐21 . A systematic review of 35 quantitative studies suggested low rates of routine domestic violence screening by practitioners (with the majority reporting between 10% and 20%) 22 From meta‐syntheses of qualitative studies, we know that health practitioners experience personal and structural barriers to domestic violence inquiry and response.…”

Section: Barriers To Inquiry and Disclosurementioning

confidence: 99%

“…A systematic review of 35 quantitative studies suggested low rates of routine domestic violence screening by practitioners (with the majority reporting between 10% and 20%) 22 From meta‐syntheses of qualitative studies, we know that health practitioners experience personal and structural barriers to domestic violence inquiry and response. Personal barriers include practitioners feeling they “can’t interfere” as domestic and sexual violence are private issues, “don’t have control” over outcomes for victims/survivors, and “won’t take responsibility” as it is someone else’s role 20 . At the structural level, practitioners perceive that “the environment works against us” with lack of time and spaces, they are “trying to tackle the problem on their own” without a team behind them, and “societal beliefs enable us to blame the victim” 19 .…”

Section: Barriers To Inquiry and Disclosurementioning

confidence: 99%

Transforming health settings to address gender‐based violence in Australia

Hegarty

Andrews

Tarzia

2022

Medical Journal of Australia

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ender-based violence includes physical, psychological, sexual or economic behaviour causing harm for reasons associated with people's gender. 1 A violation of human rights, women are disproportionately affected by gender-based violence, 2 with Indigenous women and girls facing particularly high risk. 3 Globally, the gender-based violence types most widely studied are domestic and sexual violence, with 35% of women worldwide experiencing either or both during their lifetime. 2 Australian national studies show domestic violence occurs against one in six women and one in 17 men, 4 and sexual violence occurs against one in six women (mostly by someone they know) and against one in 25 men. 5 Australian Indigenous women's experiences are 35-80 times the national average. 6 Women victims/survivors experience greater fear, injuries, chronic mental and physical health issues compared with men victims/survivors, resulting in a large burden of disease, especially for childbearing women. 2,7 While national prevalence data and evidence about response for people in same-sex relationships, non-binary or transgender individuals are lacking, 8 global studies suggest high rates of both domestic and sexual violence for these groups. [9][10][11] This narrative review concentrates on domestic and sexual violence against cisgender women by men, with a particular focus on Indigenous women, who the United Nations reports experience the highest levels of violence in Australia. 3 Structural inequities underpin domestic and sexual violence across which a culture of power, control and silence permeates, impeding the safety of women and undervaluing their agency and resistance. 12 Built on a foundation of patriarchal colonialism, Australia's value system and, therefore, its service systems are inextricably bound to structures of power and oppression that subjugate Indigenous women. 12 Across these systems, there remains a deficit-focused victim-blaming narrative regarding women experiencing domestic and/or sexual violence, resulting in women's trust in services being sparse. Racism, lack of genderfocused attention and purposeful othering are additional inequities that Indigenous women face, resulting in their pathologisation and/or criminalisation, and obscuring nuanced aspects of their lived experience. 12 Under-resourcing, lack of research and inadequate legislation, all operate to compound the silencing of women's voices. Indigenous women's voices are the least heard, compromising their safety, and that of their children, at alarming rates. 13 In this narrative review, we focus on the health system, as victims/survivors are more likely to access health services (eg, general practice, sexual health, mental health, emergency care, Aboriginal community-controlled health services and maternity services) than any other professional help. 4,14 Health practitioners are ideally placed to identify domestic and sexual violence, provide a first line response, and refer on to support services. However, domestic and sexual violence continu...

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Personal barriers to addressing intimate partner abuse: a qualitative meta-synthesis of healthcare practitioners’ experiences

Cited by 28 publications

References 57 publications

Women’s experiences and expectations of intimate partner abuse identification in healthcare settings: a qualitative evidence synthesis

Women’s experiences and expectations of intimate partner abuse identification in healthcare settings: a qualitative evidence synthesis

He hit me; but it’s okay! Female submissiveness in marital abuse: A review in Indian context

Transforming health settings to address gender‐based violence in Australia

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