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

Abstract Background Healthcare practitioners (HCPs) play a crucial role in recognising, responding to, and supporting female patients experiencing intimate partner abuse (IPA). However, research consistently identifies barriers they perceive prevent them from doing this work effectively. These barriers can be system-based (e.g. lack of time or training) or personal/individual. This review of qualitative evidence aims to synthesise the personal barriers that impact HCPs’ responses to IPA. Methods Five databases were searched in March 2020. Studies needed to utilise qualitative methods for both data collection and analysis and be published between 2010 and 2020 in order to qualify for inclusion; however, we considered any type of healthcare setting in any country. Article screening, data extraction and methodological appraisal using a modified version of the Critical Appraisal Skills Program checklist for qualitative studies were undertaken by at least two independent reviewers. Data analysis drew on Thomas and Harden’s thematic synthesis approach. Results Twenty-nine studies conducted in 20 countries informed the final review. A variety of HCPs and settings were represented. Three themes were developed that describe the personal barriers experienced by HCPs: I can’t interfere (which describes the belief that IPA is a “private matter” and HCPs’ fears of causing harm by intervening); I don’t have control (highlighting HCPs’ frustration when women do not follow their advice); and I won’t take responsibility (which illuminates beliefs that addressing IPA should be someone else’s job). Conclusion This review highlights the need for training to address personal issues in addition to structural or organisational barriers. Education and training for HCPs needs to: encourage reflection on their own values to reinforce their commitment to addressing IPA; teach HCPs to relinquish the need to control outcomes so that they can adopt an advocacy approach; and support HCPs’ trust in the critical role they can play in responding. Future research should explore effective ways to do this within the context of complex healthcare organisations.

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Women’s experiences and expectations after disclosure of intimate partner abuse to a healthcare provider: A qualitative meta-synthesis

BMJ Open ◽

10.1136/bmjopen-2020-041339 ◽

2020 ◽

Vol 10 (11) ◽

pp. e041339

Author(s):

Laura Tarzia ◽

Meghan A Bohren ◽

Jacqui Cameron ◽

Claudia Garcia-Moreno ◽

Lorna O'Doherty ◽

...

Keyword(s):

Healthcare Provider ◽

Low Income ◽

Best Practice ◽

Partner Abuse ◽

Healthcare Setting ◽

Intimate Partner Abuse ◽

Intimate Partner ◽

Cochrane Library ◽

Women’S Experiences ◽

Women's Experiences

ObjectiveTo identify and synthesise the experiences and expectations of women victim/survivors of intimate partner abuse (IPA) following disclosure to a healthcare provider (HCP).MethodsThe databases MEDLINE, Embase, CINAHL, PsychINFO, SocINDEX, ASSIA and the Cochrane Library were searched in February 2020. Included studies needed to focus on women’s experiences with and expectations of HCPs after disclosure of IPA. We considered primary studies using qualitative methods for both data collection and analysis published since 2004. Studies conducted in any country, in any type of healthcare setting, were included. The quality of individual studies was assessed using an adaptation of the Critical Appraisal Skills Programme checklist for qualitative studies. The confidence in the overall evidence base was determined using Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-Confidence in the Evidence from Reviews of Qualitative Research methods. Thematic synthesis was used for analysis.ResultsThirty-one papers describing 30 studies were included in the final review. These were conducted in a range of health settings, predominantly in the USA and other high-income countries. All studies were in English. Four main themes were developed through the analysis, describing women’s experiences and expectations of HCPs: (1) connection through kindness and care; (2) see the evil, hear the evil, speak the evil; (3) do more than just listen; and (4) plant the right seed. If these key expectations were absent from care, it resulted in a range of negative emotional impacts for women.ConclusionsOur findings strongly align with the principles of woman-centred care, indicating that women value emotional connection, practical support through action and advocacy and an approach that recognises their autonomy and is tailored to their individual needs. Drawing on the evidence, we have developed a best practice model to guide practitioners in how to deliver woman-centred care. This review has critical implications for practice, highlighting the simplicity of what HCPs can do to support women experiencing IPA, although its applicability to low-income and-middle income settings remains to be explored.

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Long-Term Consequences of Intimate Partner Abuse on Physical Health, Emotional Well-Being, and Problem Behaviors

Journal of Interpersonal Violence ◽

10.1177/0886260515609582 ◽

2015 ◽

Vol 33 (4) ◽

pp. 539-570 ◽

Cited By ~ 8

Author(s):

Sara B. Simmons ◽

Kelly E. Knight ◽

Scott Menard

Keyword(s):

Physical Health ◽

Problem Behaviors ◽

Partner Abuse ◽

Intimate Partner Abuse ◽

Well Being ◽

Intimate Partner ◽

Future Research ◽

Men And Women ◽

Youth Survey ◽

Nationally Representative

This study examines the physical health, emotional well-being, and problem behavior outcomes associated with intimate partner abuse (IPA) victimization and perpetration experiences by analyzing a nationally representative, prospective, and longitudinal sample of 879 men and women collected from the National Youth Survey Family Study (NYSFS) and assessed across a period of 9 years from 1993 to 2003. Using multivariate regression techniques, it was found that both men and women experience numerous negative outcomes associated with their IPA victimization and perpetration experiences. Implications of these findings are discussed, as are the study’s limitations, and future research directions.

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Exploring Male Students’ Lived Experiences of Intimate Partner Abuse from a Female Partner and Help-seeking

10.26686/wgtn.17145851 ◽

2021 ◽

Author(s):

◽

Jakob Scotts-Bahle

Keyword(s):

Help Seeking ◽

Partner Abuse ◽

Intimate Partner Abuse ◽

Intimate Partner ◽

Male Students ◽

Future Research ◽

Cultural Groups ◽

Student Sample ◽

Abusive Relationship ◽

The Relationship

<p>This research investigated how male university students who have experienced abuse from a female intimate partner made sense of this abuse and their help seeking experiences. Students who indicated having experienced some form of Intimate Partner Abuse (IPA) were identified through a screening questionnaire and invited to take part in this study. In-depth interviews with seven students were analysed using interpretive phenomenological analysis. This analysis identified two themes related to the men’s experiences of IPA and help seeking. The first theme of stuck in the abusive relationship comprised four subthemes, each representing a barrier the men faced which kept them in an abusive relationship and prevented them from acting to end the abuse or from seeking help. These barriers were 1) the emotional investment the men had in the relationship, 2) living in an all-encompassing controlling environment, 3) their sense of responsibility to shoulder the burdens of the relationship, and 4) their understanding of abuse in relationships. The second theme moving on from the abuse described the process of overcoming and moving past these experiences. It comprised three subthemes: 1) how the men overcame the barriers and began moving on, 2) the slow process of supported recovery and learning, and 3) the existence of ongoing impacts related to the abuse. These findings add to the growing body of literature on IPA which has found that men can be the victims of abuse which can be serious, have lasting impacts, and for which they have difficulty seeking and receiving help. The need for policies and services which can overcome the barriers men face and that address their needs are discussed. This is the first qualitative research looking at men’s IPA victimisation with a student sample and future research is needed which looks at this phenomenon with students across countries and cultural groups and in relationships in which IPA was bidirectional.</p>

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Reassessing the Link Between Stalking and Intimate Partner Abuse

Partner Abuse ◽

10.1891/1946-6560.8.3.223 ◽

2017 ◽

Vol 8 (3) ◽

pp. 223-250 ◽

Cited By ~ 9

Author(s):

Troy E. McEwan ◽

Daniel E. Shea ◽

Julia Nazarewicz ◽

Svenja Senkans

Keyword(s):

Physical Violence ◽

Partner Abuse ◽

Area Under The Curve ◽

Intimate Partner Abuse ◽

Intimate Partner ◽

Criminal History ◽

Future Research ◽

Police Records ◽

Causal Theories ◽

The Relationship

The relationship between intimate partner abuse (IPA) and postrelationship stalking is poorly understood and estimates of how often these behaviors co-occur vary widely. This article examines and consolidates findings from extant research and provides a rigorously ascertained baseline estimate of the prevalence of IPA among ex-intimate stalkers. One hundred fifteen male participants who stalked 118 separate victims were recruited from a specialist forensic clinic in Melbourne, Australia, between 2004 and 2007 and between 2010 and 2013. Prior IPA was ascertained using information from participants and police records of family violence incidents obtained in July 2014. Prior IPA against the stalking victim was identified in 39 cases (33.1%). Criminal history, prior physical violence to other victims, SCID-II diagnosed personality disorder, and sharing children were significantly associated with IPA during the prior relationship. Multivariate modeling showed that the combination of a history of violence toward other people and sharing children with the victim effectively discriminated between stalkers who did and did not engage in prior IPA (area under the curve = .74, 95% confidence interval of [.64, .83], p = .000). Findings are interpreted in light of existing causal theories of IPA and ex-intimate stalking. Areas for future research to facilitate better understanding of the relationship between these common and damaging forms of violence are highlighted.

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