Access and utilisation of maternity care for disabled women who experience domestic abuse:a systematic review

BACKGROUND: Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services. METHODS: Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement. RESULTS: Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse. CONCLUSIONS: Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base

"Young people, adult worries": RCT of an internet-based self-support method "Feel the ViBe" for children, adolescents and young adults exposed to family violence, a study protocol

Contains fulltext : 116440.pdf (publisher's version ) (Open Access)BACKGROUND: Violence in families affects children. Exposure to violence is seen as child abuse. Figures show that about one third of children exposed to violence become victim or perpetrator in their adult life: known as intergenerational transmission. Violence also affects sexual and reproductive health. To prevent problems in adult life, children need help and support. However, while trying to protect their parents, children often do not seek help, or perceive the threshold as too high. Since almost all children of the current generation have access to the internet, an online intervention will make help better available for this target group. In 2011, an internet-based self-support method for children, adolescents and young adults exposed to family violence was developed in the Netherlands: "Feel the ViBe". The intervention was developed in close collaboration with the target group. This article describes the protocol of the RCT to study the effectiveness of this intervention. METHODS/DESIGN: This study is a randomized controlled trial using the method of minimization to randomize the participants in two parallel groups with a 1:1 allocation ratio, being an intervention group, having access to "Feel the ViBe" and usual care (UC), and a control group, having access to minimally enhanced usual care (mEUC) followed by access to the intervention after twelve weeks. Outcomes are measured with questionnaires on PTSD symptoms, mental health and sexual and reproductive health. Routine Outcome Measurement (ROM) will be used to measure a direct effect of participating in the intervention. Data from a web evaluation questionnaire (WEQ), user statistics and qualitative analysis of online data will be used to support the findings. To compare results Cohen's d effect sizes will be used. DISCUSSION: A RCT and process evaluation will test effectiveness and provide information of how the effects can be explained, how the intervention meets the expectation of participants and which possible barriers and facilitators for implementation exist. A qualitative analysis of the data will add information to interpret the quantitative data. This makes "Feel the ViBe" unique in its field. TRIAL REGISTRATION: The Netherlands National Trial Register (NTR), trial ID NTR3692.11 p

Prevalence of intimate partner violence among migrant and native women attending general practice and the association between intimate partner violence and depression

Item does not contain fulltextOBJECTIVE: To explore the prevalence of intimate partner violence (IPV) of women (aged >18 years) attending general practice and to assess the association between IPV and depression. METHODS: A cross-sectional survey was conducted within 15 general practices across Rotterdam. The study population was all women older than 18 years of age attending general practice. Women were screened for sociodemographic factors, IPV and depression using the Composite Abuse Scale and the Beck Depression Inventory. RESULTS: This study had a response rate of 63% (221 of 352 women). Two hundred and fourteen women were included in the study of whom 41% were migrants. Thirty per cent of the women attending general practise ever experienced IPV. Migrants experienced IPV 1.5 times more often compared to Dutch women. A significant association between IPV and depression was found. Half of the abused women were suffering from a depression. More than three-quarter of depressed women ever experienced IPV. CONCLUSIONS: IPV is common in women attending general practice and it is significantly associated with depression. To improve recognition of abused women, doctors should ask depressed women if they ever experienced IPV

Healthcare utilization by abused women: a case control study.

Item does not contain fulltextBACKGROUND: Previous studies observed an association between intimate partner violence (IPV) and increased health problems. Early detection of IPV by general practitioners (GPs) is required to prevent further harm and provide appropriate support. In general practice, a limited number of studies are available on healthcare utilization of abused women. OBJECTIVES: The aim of the study was to investigate the healthcare utilization of abused women compared to non-abused. METHODS: The study was designed as a matched case-control study in 16 general practices in deprived areas in Rotterdam (The Netherlands). Electronic medical files of 50 victims of IPV were analysed for consultation frequency, referrals, medical prescription and reasons for encounter over a period of five years. Controls (n= 50) were non-abused women matched for general practice, age, number of children, and country of origin and education level. RESULTS: Abused women visited their GP almost twice as often than non-abused, in particular for social problems (OR= 3.5; 95%CI: 1.2-10.5; P= 0.01), substance abuse (OR= 4.6; 95%CI: 0.9-22.7; P= 0.05) and reproductive health problems (OR= 3.0; 95%CI: 1.3-6.8; P= 0.009). Victims of IPV were significantly more often referred for additional diagnostics (OR= 3.6; 95%CI: 1.1-12.2; P= 0.03), to mental healthcare (OR= 2.9; 95%CI: 1.2-7.1; P= 0.02) than non-victims. Abused women received 4.1 times more often a prescription for anti-depressants (95%CI: 1.5-11.6; P= 0.005) than non-abused women. CONCLUSION: As compared to non-abused women, female victims of IPV visited their GP more frequently and exhibited a typical pattern of healthcare utilization. This could alert GPs to inquire about partner abuse in the past.1 juni 201