Screening for Intimate Partner Violence when Children are Present The Victim\u27s Perspective

Although intimate partner violence (IPV) is routinely encountered in health care, it often goes undetected. Medical organizations recommend routine screening of women alone without children or partner. Separating a mother from her children may not be feasible in busy practices. Therefore, screening may not occur. Little research has examined women\u27s desires about IPV screening in front of their children. This study interviewed 32 mothers/survivors who were in either an IPV shelter or support group regarding their wishes about IPV screening and discussions in front of their children. Interviews were audio taped, transcribed, and analyzed using thematic analysis techniques. Major themes included mothers\u27 comfort with the use of general IPV screening questions in front of children ages 3 to 12 years. In summary, most mothers/ survivors were comfortable with physicians using general questions to screen for IPV but preferred in-depth discussions about the abuse and resource sharing in private

Screening for Intimate Partner Violence when Children are Present The Victim\u27s Perspective

Although intimate partner violence (IPV) is routinely encountered in health care, it often goes undetected. Medical organizations recommend routine screening of women alone without children or partner. Separating a mother from her children may not be feasible in busy practices. Therefore, screening may not occur. Little research has examined women\u27s desires about IPV screening in front of their children. This study interviewed 32 mothers/survivors who were in either an IPV shelter or support group regarding their wishes about IPV screening and discussions in front of their children. Interviews were audio taped, transcribed, and analyzed using thematic analysis techniques. Major themes included mothers\u27 comfort with the use of general IPV screening questions in front of children ages 3 to 12 years. In summary, most mothers/ survivors were comfortable with physicians using general questions to screen for IPV but preferred in-depth discussions about the abuse and resource sharing in private

How Children Affect the Mother/Victim\u27s Process in Intimate Partner Violence

Background Witnessing intimate partner violence (IPV) causes physical and mental health problems for children. Children are one of multiple factors that a victim weighs as she manages the abusive relationship. Little has been written about how children affect the mother\u27s decisions about the abuse or what assistance a mother wants from the children\u27s physician in creating a nonabusive home. Objective To consider the role children play in their mothers\u27 management of abusive partners. Methods Thirty-two mothers living in Midwestern IPV shelters or participating in support groups were interviewed about their abuse stories, perceptions about the effects of the abuse on their children, and desires about IPV management in the health care setting. The interviews were audiotaped, transcribed, and analyzed by a team of researchers using thematic analysis. Results Children were an integral factor in the mothers\u27 management of their abusive relationships. For more than half of the participants, something the children did or said catalyzed their seeking help. For some, the children\u27s attachment to the abuser was a reason to delay seeking assistance. Based on these findings, we explored what mothers wanted from their children\u27s physicians regarding their abusive relationships. Mothers talked about the delicate balance between education and blame, between offering help and becoming too intrusive, and between wanting the best for their children and fearing the involvement of child protective services. Conclusions Children play an important role in mothers\u27 management of their abusive relationships. From their children\u27s physicians, participants wanted IPV screening and IPV resources. Some wanted the physician to educate them about how the IPV affected the children in a nonblaming manner

How Children Affect the Mother/Victim\u27s Process in Intimate Partner Violence

Background Witnessing intimate partner violence (IPV) causes physical and mental health problems for children. Children are one of multiple factors that a victim weighs as she manages the abusive relationship. Little has been written about how children affect the mother\u27s decisions about the abuse or what assistance a mother wants from the children\u27s physician in creating a nonabusive home. Objective To consider the role children play in their mothers\u27 management of abusive partners. Methods Thirty-two mothers living in Midwestern IPV shelters or participating in support groups were interviewed about their abuse stories, perceptions about the effects of the abuse on their children, and desires about IPV management in the health care setting. The interviews were audiotaped, transcribed, and analyzed by a team of researchers using thematic analysis. Results Children were an integral factor in the mothers\u27 management of their abusive relationships. For more than half of the participants, something the children did or said catalyzed their seeking help. For some, the children\u27s attachment to the abuser was a reason to delay seeking assistance. Based on these findings, we explored what mothers wanted from their children\u27s physicians regarding their abusive relationships. Mothers talked about the delicate balance between education and blame, between offering help and becoming too intrusive, and between wanting the best for their children and fearing the involvement of child protective services. Conclusions Children play an important role in mothers\u27 management of their abusive relationships. From their children\u27s physicians, participants wanted IPV screening and IPV resources. Some wanted the physician to educate them about how the IPV affected the children in a nonblaming manner

Medical Management of Intimate Partner Violence Considering the Stages of Change: Precontemplation and Contemplation

BACKGROUND We undertook a study to understand how women who are victims of intimate partner violence (IPV) want physicians to manage these abusive relationships in the primary care office. METHODS Thirty-two mothers in IPV shelters or support groups in southwestern Ohio were interviewed to explore their abuse experiences and health care encounters retrospectively. The interviews were taped and transcribed. Using thematic analysis techniques, transcripts were read for indications of the stages of change and for participants’ desires concerning appropriate physician management. RESULTS Participants believed that physicians should screen women for IPV both on a routine basis and when symptoms indicating possible abuse are present, even if the victim does not disclose the abuse. Screening is an important tool to capture those women early in the process of victimization. When a victim does not recognize her relationship as abusive, participants recommended that physicians raise the issue by asking, but they also warned that doing more may alienate the victim. Participants also encouraged physicians to explore clues that victims might give about the abuse. In later contemplation, victims are willing to disclose the abuse and are exploring options. Physicians were encouraged to affirm the abuse, know local resources for IPV victims, make appropriate referrals, educate victims about how the abuse affects their health, and document the abuse. Participants identified a variety of internal and external factors that had affected their processes. CONCLUSIONS In hindsight, IPV victims recommended desired actions from physicians that could help them during early stages of coming to terms with their abusive relationships. Stage-matched interventions may help physicians manage IPV more effectively and avoid overloading the victim with information for which she is not ready

Cohort, Period, and Aging Effects A Qualitative Study of Older Women’s Reasons for Remaining in Abusive Relationships

To understand women’s reasons for continuing long-term abusive relationships, inter-views were conducted with 36 women who were over the age of 55. These women matured during times of sweeping social changes with the feminist, battered women’s, and elder abuse movements. Reasons for remaining were organized into three categories: cohort, period, and aging effects. Cohort effects included reasons similar to those of younger women such as lacking education or job skills. Period effects related to efforts to seek help early in the abusive relationship and receiving little assistance from society’s social institutions. Finally, aging effects dealt with how the health challenges of physical age limited options

Cohort, Period, and Aging Effects A Qualitative Study of Older Women’s Reasons for Remaining in Abusive Relationships

To understand women’s reasons for continuing long-term abusive relationships, inter-views were conducted with 36 women who were over the age of 55. These women matured during times of sweeping social changes with the feminist, battered women’s, and elder abuse movements. Reasons for remaining were organized into three categories: cohort, period, and aging effects. Cohort effects included reasons similar to those of younger women such as lacking education or job skills. Period effects related to efforts to seek help early in the abusive relationship and receiving little assistance from society’s social institutions. Finally, aging effects dealt with how the health challenges of physical age limited options

Hidden Victims: The Healthcare Needs and Experiences of Older Women in Abusive Relationships

Background: Intimate partner violence (IPV) is a problem in older women, but older victims of IPV are often unidentified in the medical setting because providers think of IPV as a problem of younger women. The experiences of older women with IPV are unknown. This study reports on the healthcare experiences and needs of older victims of IPV. Methods: Interviews were conducted with 38 women \u3e55 years who responded to an advertisement recruiting women who had been in an abusive relationship since age 55. Interviews were audiotaped, transcribed, and analyzed for themes. Results: The median age of participants was 58 years (range 55–90). The majority were Caucasian with annual incomes over $40,000. The median relationship length was 24 years (range 2–67), and 39% remained in their abusive relationships. About half had discussed IPV with a healthcare provider. The themes that were identified included disclosure about IPV and both negative and positive experiences with healthcare providers. Reasons for nondisclosure were similar to those of younger women but were compounded by the generational mores of privacy about domestic affairs and society\u27s lack of understanding and resources for IPV. Some of the women who disclosed IPV to their providers felt discounted and unsupported. Others reported receiving valuable help, including empathy, referrals to resources, assistance in naming the abuse, linking the stress of IPV to health, and respect for their decisions to continue their abusive relationships. Conclusions: Older women victims have difficulty initiating discussions about IPV with their providers. Providers are encouraged to identify signals of potential abuse and to create privacy with all patients to discuss difficult issues, such as IPV, and to be knowledgeable about appropriate referrals

Hidden Victims: The Healthcare Needs and Experiences of Older Women in Abusive Relationships

Background: Intimate partner violence (IPV) is a problem in older women, but older victims of IPV are often unidentified in the medical setting because providers think of IPV as a problem of younger women. The experiences of older women with IPV are unknown. This study reports on the healthcare experiences and needs of older victims of IPV. Methods: Interviews were conducted with 38 women \u3e55 years who responded to an advertisement recruiting women who had been in an abusive relationship since age 55. Interviews were audiotaped, transcribed, and analyzed for themes. Results: The median age of participants was 58 years (range 55–90). The majority were Caucasian with annual incomes over $40,000. The median relationship length was 24 years (range 2–67), and 39% remained in their abusive relationships. About half had discussed IPV with a healthcare provider. The themes that were identified included disclosure about IPV and both negative and positive experiences with healthcare providers. Reasons for nondisclosure were similar to those of younger women but were compounded by the generational mores of privacy about domestic affairs and society\u27s lack of understanding and resources for IPV. Some of the women who disclosed IPV to their providers felt discounted and unsupported. Others reported receiving valuable help, including empathy, referrals to resources, assistance in naming the abuse, linking the stress of IPV to health, and respect for their decisions to continue their abusive relationships. Conclusions: Older women victims have difficulty initiating discussions about IPV with their providers. Providers are encouraged to identify signals of potential abuse and to create privacy with all patients to discuss difficult issues, such as IPV, and to be knowledgeable about appropriate referrals