Reconceptualising health and health care for women affected by domestic violence

Abstract

Domestic violence is a major public health issue that influences all aspects of affected women's lives (World Health Organisation, 2010). Women who are subjected to domestic violence seek help from a wide range of professionals within health and social care sectors, and evidence suggests that their experiences tend to be negative. We argue that current approaches are based on responses that are medically informed and provide an alternate lens from which to view women's health care needs. This paper reports on the findings of the second phase of a two-phase study. The first phase of the study reported on women's emerging health needs, efforts to seek help and experiences of seeking healthcare. The second phase examined how nurses constructed the health and health issues of women affected by domestic violence when women presented for health care. This paper brings together the findings of both phases to argue there is a disconnection in women's experiences and needs and how nurses construct needs and deliver care. Biographical disruption is a new lens from which to view women's experiences and is a framework which highlights how women experience significant dislocation of their sense of self as a result of domestic violence.

How Equity‐Oriented Health Care Affects Health: Key Mechanisms and Implications for Primary Health Care Practice and Policy

“…32 There is also consistent evidence that people who experience health and social inequities are more likely to report both negative experiences of health care, including stigma and various types of discrimination, and a poor fit between services that are offered and their needs. 10 Furthermore, negative health care experiences have been linked to delays in seeking care in varied populations, including people experiencing homelessness or poverty; 33 people living with mental illness 34 or chronic illness; 35 those with histories of violence or trauma; 36 and those identifying as lesbian, gay, bisexual, transgender, 37,38 or Indigenous. 39,40 There is an urgent need to develop and test the impacts of primary health care approaches that explicitly attend to issues of equity and to identify the mechanisms by which such care may improve health and quality of life and potentially reduce health inequities.…”

The Emergency Department Response to Women Experiencing Intimate Partner Violence: Insights From Interviews With Clinicians in Australia

“…One New Zealand study interviewed 11 emergency nurses about screening for partner abuse finding that nurses who felt comfortable asking women about IPV were more likely to do so. Two Australian studies investigated the attitudes, perspectives, and practices of emergency nurses reporting that nurses distanced themselves from women and felt that they were lacking in skills and institutional support to adequately respond. There is therefore a lack of studies examining the characteristics that shape team work, decision making, practice, and approaches to IPV by emergency clinicians.…”

Patient and Provider Emergency Care Experiences Related to Intimate Partner Violence: A Systematic Review of the Existing Evidence

“…On the individual level, nurses and physicians noted positive experiences when able to support patients' autonomy and offer useful services to patients (Fay-Hillier, 2016;Loughlin et al, 2000;Ritchie et al, 2009;Tower et al, 2012). Providers felt that making a difference even for one person (Loughlin et al, 2000;Ritchie et al, 2009;Tower et al, 2012) and helping to make people feel safe were important to them (Tower et al, 2012). Additional contributors to positive experiences included feeling knowledgeable and well-equipped to manage IPV in the ED (Loughlin et al, 2000;McGarry & Nairn, 2015).…”

“…Finally, providers held stereotypes and perpetuated bias related to IPV, such as thoughts that patients experiencing IPV were not reliable (Fay-Hillier, 2016;Maina, 2009;O'Doherty et al, 2016;Robinson, 2010;Sormanti & Smith, 2009;Tower et al, 2012;Zijlstra et al, 2017), were embellishing their stories or lying for their own benefit (Fay-Hillier, 2016;Loke et al, 2012;Pratt-Eriksson et al, 2014;Tower et al, 2012), were responsible for their experiences of violence (Inoue & Armitage, 2006;Robinson, 2010;Sormanti & Smith, 2009), were drug (Mayer, 2000) or attention-seeking (Fay-Hillier, 2016), were unkept or impoverished (Inoue & Armitage, 2006;Tower et al, 2012), were intoxicated (Fay-Hillier, 2016; Inoue & Armitage, 2006;Tower et al, 2012), and/or were mentally ill (Fay-Hillier, 2016).…”