The Domestic Violence Survivor Assessment (DVSA): a tool for individual counseling with women experiencing intimate partner violence

Help-Seeking Behaviors for Intimate Partner Violence Among College Students: Implications for Intimate Partner Violence Prevention and Intervention

This study applied Andersen's Model of Health Service Use to examine help-seeking behaviors for intimate partner violence (IPV) and predisposing, enabling, and need factors for help-seeking among college students. The sample (N = 2,719) consisted of those who experienced IPV and was recruited from six universities in the United States and one university in Canada through an online survey. Results showed that 45.4% of the sample had sought some form of help for IPV. The most utilized source of formal help was from medical services, and friends were the number one source of informal help. Gender, age, sexual orientation (predisposing factors), IPV training (enabling factor), experiencing psychological and technological violence, and IPV consequences (need factors) were associated with seeking help. Implications for research and practice are discussed.

Adapted tool for the assessment of domestic violence against women in a low-income country setting: a reliability analysis

Background

One-in-three women has experienced domestic violence, which is a serious public health problem and a human right violation. Domestic violence is a common life experience among women in Ethiopia. The tool used to assess violence against women (VAW) has not been validated to assess its consistency. Cronbach's alpha (α, or coefficient alpha) is a measure of internal consistency, or reliability, that is, how closely a set of items are related as a group. Reliability is how well a test measures what it should. Therefore, the aim of this study was to estimate the inter-item correlation (reliability) of the tool adapted from literature.

Methods

A community-based study was conducted in Northwestern Ethiopia between November 15, 2017 and December 31, 2017. A total of 1,269 women at their permanent place of residence (specifically at their households) were recruited using the multistage stratified systematic sampling method. A structured questionnaire was adapted from literature. Also, 12 trained female data collectors collected the data using the face-to-face interview method. Data were entered into EpiData 3.1.0 and exported to SPSS 23.0 for analysis. Descriptive statistical analysis was carried out to estimate the reliability of the response(s).

Results

Overall, Cronbach's alpha was higher than the minimum recommended value of 0.70. Cronbach's alpha for specific sections were 0.764 for women's decision-making autonomy (13 items); women's accepting attitude toward justified wife-beating (five items, 0.894); physical violence (seven items, 0.876); psychological violence (15 items, 0.925); sexual violence (five items, 0.812); and inequitable gender-norms (seven items, 0.867).

Conclusion

The tool used to assess domestic VAW in Northwestern Ethiopia had a high reliability. Therefore, researchers can adapt the tool and further assess its reliability in other settings to have a common and validated tool to study VAW in a low-income countries.

Prospective evaluation of intimate partner violence in fracture clinics (PRAISE-2): protocol for a multicentre pilot prospective cohort study

Background

One third of women experience intimate partner violence (IPV) in their lifetime. Orthopaedic health care professionals are in a good position to identify women experiencing escalating physical violence and act to promote their immediate safety, connect them to IPV resources, and reduce the risk of further harm. However, there have been no studies that explore whether experiencing a musculoskeletal injury can trigger or worsen IPV, and there have been no studies on how experiences of IPV affect orthopaedic outcomes. The primary objective of the PRAISE-2 pilot study is to assess the feasibility of conducting a large cohort study to determine the association between IPV and injury-related complications. The secondary clinical objectives are to preliminarily explore how a history of IPV affects orthopaedic outcomes and how patterns of IPV change over time following an orthopaedic injury.

Methods

We will complete a pilot multicentre prospective cohort study of 250 women with musculoskeletal injuries to determine the feasibility of a multinational prospective cohort study that will determine if prior or ongoing IPV affects orthopaedic outcomes following an injury, and how patterns of IPV change over time. Our primary outcome is feasibility measured using recruitment rate (success criterion 50 patients/site in 12 months), adherence to visit windows (success criterion 75%), participant retention (success criterion 85%), and data completeness (success criterion 80%). Our secondary exploratory clinical outcomes are injury-related complications, return to function, new IPV disclosures, utilization and cost of support services, changes in abuse patterns, quality of life, and readiness to make relationship changes. We will assess feasibility based on pre-defined criteria for feasibility success and we will analyze secondary outcomes in an exploratory fashion.

Discussion

The PRAISE-2 pilot study is the first step toward determining how experiences of IPV affect orthopaedic outcomes such as injury-related complications. This study will determine feasibility and assist in the development of large-scale multinational prospective IPV studies for our future IPV research program. This study will engage health care professionals from around the world to increase awareness of how IPV affects patients' musculoskeletal and injury outcomes.

Trial registration

clinicaltrials.gov NCT02529267. Registered 20 Aug 2015.

Women survivors of intimate partner violence: the difficult transition to independence

Objective To understand the trajectories that women go through from entering into to leaving relationships involving intimate partner violence (IPV), and identify the stages of the transition process. Method We utilized a constructivist paradigm based on grounded theory. We ensured that the ethical guidelines of the World Health Organization for research on domestic violence were followed. The analysis focused on narratives of 28 women survivors of IPV, obtained from in-depth interviews. Results The results showed that the trajectories experienced by women were marked by gender issues, (self) silencing, hope and suffering, which continued after the end of the IPV. Conclusion The transition process consists of four stages: entry - falls in love and becomes trapped; maintenance - silences own self, consents and remains in the relationship; decides to leave - faces the problems and struggles to be rescued; (re) balance - (re) finds herself with a new life. This (long) process was developed by wanting (and being able to have) self-determination.

Predictors of change in mental health and distress among women attending a women's shelter

BACKGROUND

Intimate partner violence (IPV) is detrimental to mental health. The Domestic Violence Survivor Assessment (DVSA), which includes a mental health assessment, is often used to evaluate abuse survivors in a counseling situation. The DVSA seeks to outline the cognitive state of women as per the stages of change as they attempt to move toward a life with no IPV.

OBJECTIVE

The objective of this study was to explore predictors of change in mental health and distress among women who entered a women's shelter more than once.

METHODS

Women entering a women's shelter more than once over a 3-year period were assessed by a trained social worker using the DVSA. A logistic regression analysis examined relationships between the chosen characteristics and the participants' mental health through the DVSA stages of change.

RESULTS

We analyzed complete data for 94 women who entered the shelter a mean of 3.3 times (range 2-8) over a mean period of 16.1 days (range: 1-391). Thirty-six women (36/94; 38.3%) progressed through the stages. The average number of visits among women who progressed through the stages was 4. Our multivariable logistic regression showed women who had more visits to the shelter were almost twice as likely to progress through the stages compared to women who entered the shelter fewer times (OR=1.928; 95% CI=1.292-2.877; p=0.001). In the univariate analysis, only increased number of visits was significantly associated with progressing through the stages of change (OR=1.694; 95% CI=1.237-2.322; p=0.001). The other factors were not significantly associated with a change in mental health and distress (p>0.05).

CONCLUSION

Women who enter women's shelters more frequently may be more likely to progress through the DVSA mental health stages compared to other women. Women's shelters may be helpful in assisting progression through the stages of change, thereby improving their mental health after abuse.

Women's journey to safety - the Transtheoretical model in clinical practice when working with women experiencing Intimate Partner Violence: a scientific review and clinical guidance

OBJECTIVE

Review the applicability of the Transtheoretical model and provide updated guidance for clinicians working with women experiencing intimate partner violence.

METHODS

Critical review of related primary research conducted from 1990 to March 2013.

RESULTS

Women's experiences of creating change within abusive relationships can be located within a stages of change continuum by identifying dominant behavioral clusters. The processes of change and constructs of decisional-balance and turning-points are evident in women's decision-making when they engage in change.

CONCLUSION

Clinicians can use the stages of change to provide a means of assessing women's movement toward their nominated outcomes, and the processes of change, decisional-balance and turning-points, to enhance understanding of, and promote women's movement across stages in their journey to safety.

PRACTICE IMPLICATIONS

Clinicians should assess women individually for immediate and ongoing safety and well-being, and identify their overarching stage of change. Clinicians can support women in identifying and implementing their personal objectives to enhance self-efficacy and create positive change movement across stages. The three primary objectives identified for clinician support are: 1. Minimizing harm and promoting well-being within an abusive relationship, 2. Achieving safety and well-being within the relationship; halting the abuse, or 3. Achieving safety by ending/leaving intimate relationships.

Coping with dating violence as a function of violence frequency and solution attribution: a structural modeling approach

This study presents a structural model of coping with dating violence. The model integrates abuse frequency and solution attribution to relate to college women's choices of coping strategies. Three hundred and twenty-four undergraduate women reported being targets of some physical abuse from a boyfriend and responded to questions regarding the abuse, their solution attribution, and their coping behaviors. Solution attribution mediated the relation between frequency of the abuse and coping. Abuse frequency had a positive effect on external solution attribution, and external solution attribution had a positive effect on the level of use of active coping, utilization of social support, denial, and acceptance.

Psychometric properties of the Domestic Violence Survivor Assessment

Domestic Violence Survivor Assessment (DVSA) assesses the process of change using the Transtheoretical Model of Change for 12 issues conceptualized as relating to the relationship or the individual. This article presents the psychometric properties of the revised DVSA with a new item, "Control of Money." The factor analysis was done for 119 survivors resulting in a three-factor solution explaining 65.06% of the variance with a Chronbach's alpha of .89 and Mental Health as a separate, third factor. The DVSA's use for counseling and implications of the differences in responses by women and their counselors is discussed.