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Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study

BACKGROUND: Despite endorsement by national organizations, the impact of screening for intimate partner violence (IPV) is understudied, particularly as it occurs in different clinical settings. We analyzed interviews of IPV survivors to understand the risks and benefits of disclosing IPV to clinicia...

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Autores principales: Liebschutz, Jane, Battaglia, Tracy, Finley, Erin, Averbuch, Tali
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474863/
https://www.ncbi.nlm.nih.gov/pubmed/18601725
http://dx.doi.org/10.1186/1471-2458-8-229
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author Liebschutz, Jane
Battaglia, Tracy
Finley, Erin
Averbuch, Tali
author_facet Liebschutz, Jane
Battaglia, Tracy
Finley, Erin
Averbuch, Tali
author_sort Liebschutz, Jane
collection PubMed
description BACKGROUND: Despite endorsement by national organizations, the impact of screening for intimate partner violence (IPV) is understudied, particularly as it occurs in different clinical settings. We analyzed interviews of IPV survivors to understand the risks and benefits of disclosing IPV to clinicians across specialties. METHODS: Participants were English-speaking female IPV survivors recruited through IPV programs in Massachusetts. In-depth interviews describing medical encounters related to abuse were analyzed for common themes using Grounded Theory qualitative research methods. Encounters with health care clinicians were categorized by outcome (IPV disclosure by patient, discovery evidenced by discussion of IPV by clinician without patient disclosure, or non-disclosure), attribute (beneficial, unhelpful, harmful), and specialty (emergency department (ED), primary care (PC), obstetrics/gynecology (OB/GYN)). RESULTS: Of 27 participants aged 18–56, 5 were white, 10 Latina, and 12 black. Of 59 relevant health care encounters, 23 were in ED, 17 in OB/GYN, and 19 in PC. Seven of 9 ED disclosures were characterized as unhelpful; the majority of disclosures in PC and OB/GYN were characterized as beneficial. There were no harmful disclosures in any setting. Unhelpful disclosures resulted in emotional distress and alienation from health care. Regardless of whether disclosure occurred, beneficial encounters were characterized by familiarity with the clinician, acknowledgement of the abuse, respect and relevant referrals. CONCLUSION: While no harms resulted from IPV disclosure, survivor satisfaction with disclosure is shaped by the setting of the encounter. Clinicians should aim to build a therapeutic relationship with IPV survivors that empowers and educates patients and does not demand disclosure.
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spelling pubmed-24748632008-07-19 Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study Liebschutz, Jane Battaglia, Tracy Finley, Erin Averbuch, Tali BMC Public Health Research Article BACKGROUND: Despite endorsement by national organizations, the impact of screening for intimate partner violence (IPV) is understudied, particularly as it occurs in different clinical settings. We analyzed interviews of IPV survivors to understand the risks and benefits of disclosing IPV to clinicians across specialties. METHODS: Participants were English-speaking female IPV survivors recruited through IPV programs in Massachusetts. In-depth interviews describing medical encounters related to abuse were analyzed for common themes using Grounded Theory qualitative research methods. Encounters with health care clinicians were categorized by outcome (IPV disclosure by patient, discovery evidenced by discussion of IPV by clinician without patient disclosure, or non-disclosure), attribute (beneficial, unhelpful, harmful), and specialty (emergency department (ED), primary care (PC), obstetrics/gynecology (OB/GYN)). RESULTS: Of 27 participants aged 18–56, 5 were white, 10 Latina, and 12 black. Of 59 relevant health care encounters, 23 were in ED, 17 in OB/GYN, and 19 in PC. Seven of 9 ED disclosures were characterized as unhelpful; the majority of disclosures in PC and OB/GYN were characterized as beneficial. There were no harmful disclosures in any setting. Unhelpful disclosures resulted in emotional distress and alienation from health care. Regardless of whether disclosure occurred, beneficial encounters were characterized by familiarity with the clinician, acknowledgement of the abuse, respect and relevant referrals. CONCLUSION: While no harms resulted from IPV disclosure, survivor satisfaction with disclosure is shaped by the setting of the encounter. Clinicians should aim to build a therapeutic relationship with IPV survivors that empowers and educates patients and does not demand disclosure. BioMed Central 2008-07-04 /pmc/articles/PMC2474863/ /pubmed/18601725 http://dx.doi.org/10.1186/1471-2458-8-229 Text en Copyright © 2008 Liebschutz et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Liebschutz, Jane
Battaglia, Tracy
Finley, Erin
Averbuch, Tali
Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study
title Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study
title_full Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study
title_fullStr Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study
title_full_unstemmed Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study
title_short Disclosing intimate partner violence to health care clinicians - What a difference the setting makes: A qualitative study
title_sort disclosing intimate partner violence to health care clinicians - what a difference the setting makes: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474863/
https://www.ncbi.nlm.nih.gov/pubmed/18601725
http://dx.doi.org/10.1186/1471-2458-8-229
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