“ I Just Keep My Antennae Out ”

Jennifer S. McCall‐Hosenfeld · Carol Sachs Weisman · Amanda N. Perry · Marianne M. Hillemeier · Cynthia H. Chuang

38 citations0/0 files storedJournal of Interpersonal Violence

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Intimate Partner and Family Violence Sexual Assault and Victimization Studies Elder Abuse and Neglect

Abstract

Women in rural communities who are exposed to intimate partner violence (IPV) have fewer resources when seeking help due to limited health services, poverty, and social isolation. Rural primary care physicians may be key sources of care for IPV victims. The objective of this study was to assess the opinions and practices of primary care physicians caring for rural women with regard to IPV identification, the scope and severity of IPV as a health problem, how primary care providers respond to IPV in their practices, and barriers to optimized IPV care in their communities. Semistructured interviews were conducted with 19 internists, family practitioners, and obstetrician-gynecologists in rural central Pennsylvania. Interview transcripts were analyzed for major themes. Most physicians did not practice routine screening for IPV due to competing time demands, lack of training, limited access to referral services as well as low confidence in their effectiveness, and concern that inquiry would harm the patient-doctor relationship. IPV was considered when patients presented with symptoms of mood, anxiety, or somatic disorders. Responses to IPV included validation, danger assessment, safety planning, referral, and follow-up planning. Perceived barriers to rural women seeking help for IPV included traditional gender roles, lower education, economic dependence on the partner, low self-esteem, and patient reluctance to discuss IPV. To overcome barriers, physicians created a "safe sanctuary" to discuss IPV and suggested improved public health education and referral services. Interventions to improve IPV-related care in rural communities should address barriers at multiple levels, including both physicians' and patients' comfort with discussing IPV. Provider training, community education, and improved access to referral services are key areas in which IPV-related care should be improved in rural communities. Our data support routine screening to better identify IPV and a more pro-active stance toward screening and counseling.

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References

2005Three Approaches to Qualitative Content Analysis 2005How Many Interviews Are Enough?2001Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?2002Physical and mental health effects of intimate partner violence for men and women 1994Collecting data using a semi‐structured interview: a discussion paper 2004The Sage encyclopedia of social science research methods 2000Physical Health Consequences of Physical and Psychological Intimate Partner Violence 2002Intimate Partner Violence and Physical Health Consequences

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