scholarly journals Improving the response of primary care providers to rural First Nation women who experience intimate partner violence: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kristin Rizkalla ◽  
Marion Maar ◽  
Roger Pilon ◽  
Lorrilee McGregor ◽  
Maurianne Reade

Abstract Background Some legacies of colonialism are that Indigenous women living in Canada experience higher rates of intimate partner violence (IPV) and that violence is often more severe relative to non-Indigenous women. This results in avoidable physical, psychological, emotional, financial, sexual and spiritual harm in the lives of Indigenous women, families, and communities. Trusted primary care providers are well positioned to provide brief interventions and referrals to treatment and services, but little is known about the providers’ preparedness to support Indigenous women. Information on what enables or prevents providers to respond to Indigenous patients who experience IPV is needed in order to ensure this potential lifeline for support is realized. Methods The purpose of this community-based participatory study was to elucidate the barriers and facilitators to care for rural Indigenous women who experience IPV from the perspectives of primary care providers and to recommend strategies to improve their preparedness. Using a Grounded Theory approach, we conducted qualitative research with 31 providers to discuss their experiences with patients affected by IPV. Results The results showed providers often feel a degree of unpreparedness to deal with IPV in a clinical setting. Underlying the feelings of unpreparedness were: Recognition of patients’ under disclosure of IPV due to stigma, shame and fear Lack of formal provider training on appropriate approaches to IPV Lack of referral network due to fragmented, scarce services for IPV Lack of understanding of jurisdictional complexity of First Nations and non-First Nations specific services for IPV Uncertainty how to negotiate cultural safety around IPV Multiple-role relationship & confidentiality dilemmas characteristic of small communities Risk of jeopardizing patient-provider relationship Conclusions Our recommendations to improve provider preparedness to address IPV include reducing the stigma of IPV; creating effective referral pathways; improving cultural safety within the referral network; developing services for perpetrators; engaging natural helpers in the community, and; developing policies, procedures and continuing education related to patients who experience IPV in the clinical and community setting. We suggest that increasing providers’ comfort to respond to IPV for rural and Indigenous women will ultimately lead to improved safety and health outcomes.

2013 ◽  
Vol 28 (8) ◽  
pp. 823-831 ◽  
Author(s):  
Katherine M. Iverson ◽  
Stephanie Y. Wells ◽  
Shannon Wiltsey-Stirman ◽  
Rachel Vaughn ◽  
Megan R. Gerber

2014 ◽  
Vol 29 (4) ◽  
pp. 652-669 ◽  
Author(s):  
Kate Joyner ◽  
Bob Mash

Intimate partner violence (IPV) makes a substantial contribution to the burden of disease in South Africa. This article explores the current quality of care for IPV in public sector primary care facilities within the Western Cape. Only 10% of women attending primary care, while suffering from IPV, were recognized. Case studies, based on in-depth interviews and medical records, were used to reflect on the quality of care received among the women who were recognized. Care tended to be superficial, fragmented, poorly coordinated, and lacking in continuity. The recognition, management, and appropriate documentation of IPV should be prioritized within the training of primary care providers. It may be necessary to appoint IPV champions within primary care to ensure comprehensive care for survivors of IPV.


2019 ◽  
pp. 088626051987229
Author(s):  
E. Briones-Vozmediano ◽  
E. Castellanos-Torres ◽  
I. Goicolea ◽  
C. Vives-Cases

The objective of this study is to identify challenges and facilitators for detecting and addressing cases of intimate partner violence (IPV) against Roma women, from the perspectives of health personnel and representatives of Roma organizations, and to compare both perspectives. A total of 28 semi-structured interviews were carried out between November 2014 and February 2015 in different Spanish cities. A thematic analysis was carried out, guided by Aday and Andersen’s model regarding barriers to access to health services. Both groups signaled the following as principal challenges: (a) consideration of IPV as a private problem among the Roma population, (b) little use of primary care providers for prevention, (c) distrust of Roma women toward primary care professionals as resources for seeking help, (d) the inexistence of Roma professionals in health services, (e) health professionals’ lack of cultural sensitivity related to Roma people, and (f) the focus of health protocols for action against IPV on filing a police report. Potential facilitating factors included Roma women’s trust in nurses, social workers, and pediatricians and ethnic heterogeneity. There is need to promote action to address the identified challenges through a health equity approach that includes greater training and awareness raising among health professionals about Roma culture and the specific needs of Roma women.


2016 ◽  
Vol 18 (5) ◽  
pp. 479-495 ◽  
Author(s):  
Carmen Alvarez ◽  
Gina Fedock ◽  
Karen Trister Grace ◽  
Jacquelyn Campbell

Background: Primary care providers have an important role in identifying survivors of intimate partner violence (IPV) and providing safety options. Routine screening rates by providers have been consistently low, indicating a need to better understand providers’ practices to ensure the translation of policy into clinical practice. Aim: This systematic review examines common themes regarding provider screening practices and influencing factors on these practices. Method: A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search focused on research articles which met the following criteria: (1) health-care providers as participants, (2) provider reports on screening and counseling practices for IPV, and (3) were in English or Spanish. Results: A total of 35 studies were included in the review. Across studies, providers commonly acknowledged the importance of IPV screening yet often used only selective screening. Influencing factors on clinic, provider, and patient levels shaped the process and outcomes of provider screening practices. Overall, a great deal of variability exists in regard to provider screening practices. This variability may be due to a lack of clear system-level guidance for these practices and a lack of research regarding best practices. Conclusions: These findings suggest the necessity of more facilitative, clearly defined, and perhaps mandatory strategies to fulfill policy requirements. Future research directions are outlined to assist with these goals.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Kristin Rizkalla ◽  
Marion Maar ◽  
Lorrilee McGregor ◽  
Roger Pilon ◽  
Maurianne Reade

Most Indigenous intimate partner violence (IPV) research and interventions are geared toward women, while the experiences of Indigenous men as survivors of IPV are not well investigated or understood. Indigenous men are typically portrayed as perpetrators of violence yet very seldom as survivors of violence, although they experience disproportionately high rates of violence, including IPV, when compared to non-Indigenous men. Our community-based participatory research, conducted in partnership with First Nations communities in Northern Ontario, Canada, completed in 2019, identified this bias as a major barrier for Indigenous men to disclose IPV in a health service setting, where a safe space and support should be available. The primary health care providers involved in this study reported awareness of serious abuse perpetrated against First Nations men in heterosexual relationships. However, they also cited insufficient preparedness within the primary care system to respond to the needs of these men, including significant gaps in culturally safe services. These findings warrant attention and action. We offer recommendations for health and social services and community organizations to help address, in culturally safe ways, IPV experienced by Indigenous men and its effects on families and communities.


2021 ◽  
pp. 088626052110014
Author(s):  
Rob Stephenson ◽  
Lynae A. Darbes ◽  
Matthew T Rosso ◽  
Catherine Washington ◽  
Lisa Hightow-Weidman ◽  
...  

There has been a growth in research illustrating that gay, bisexual, and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates that are comparable to those among heterosexual women. However, the majority of research on IPV among same-sex male couples has focused on adults, and research on the experience of IPV among younger men (those aged under 18), remains at a nascent stage, despite knowledge that IPV is often common among younger men. This article adds to the growing body of literature on IPV among young GBMSM (YGBMSM) through of an analysis of qualitative data from in-depth interviews (IDI) with GBMSM aged 15–19 ( n = 30) in romantic relationships partnerships. The study sought to explore issues of relationship development, relationship contexts, and understandings of IPV. More than one-half of the sample reported experiencing some form of IPV in their current or past relationships. Participants described a range of experiences of IPV, including physical IPV, emotional IPV, sexual IPV, and controlling behaviors. Emotional IPV in the form of negative comments and controlling behaviors such as jealousy were the most commonly reported forms of violence behaviors. Although few participants reported experiencing physical or sexual IPV, several discussed concerns about giving, and partners’ acknowledging, sexual consent. Antecedents to IPV included wanting or feeling pressured to participate in normative development milestones, short-lived relationships, and societal stigma. Interventions that develop content on IPV and that reflect the lived realities of YGBMSM who are experiencing their first relationships are urgently needed. Study findings also support the need for training teachers, health care providers, and parents to identify signs of IPV and provide them with the knowledge and skills to talk to YGBMSM about relationships and violence to reduce IPV.


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