Health and Health Care From the Perspective of Intimate Partner Violence Adult Female Victims in Shelters: Impact of IPV, Unmet Needs, Barriers, Experiences, and Preferences

The Association Between Victimization and Perpetration of Physical Intimate Partner Violence and Unmet Healthcare Needs Among Married Women in South Korea

This study assessed physical intimate partner violence (IPV) experiences and examined their association with unmet healthcare needs among married women in South Korea. We analyzed data from a nationally representative longitudinal survey of 6,533 women at baseline. Participants were asked yes/no questions about their experiences of physical IPV victimization and perpetration over the past year. The responses were classified into four categories of IPV experience: "none," "victimization only," "perpetration only," and "both victimization and perpetration." At baseline, 0.9% reported being victimized only, and 25.9% reported both victimization and perpetration. The prevalence of unmet healthcare needs over the past year at baseline was 0.8%. Compared to women without any IPV experience, women in the IPV "victimization only" category had greater unmet healthcare needs (OR: 5.49, 95% CI [2.30, 13.12]) after adjusting for sociodemographic variables. Experiencing IPV perpetration only and both IPV victimization and perpetration were not statistically significantly associated with unmet healthcare needs. These results imply that physical IPV victims face difficulties accessing healthcare services which could exacerbate health inequalities over time. Moreover, this study suggests that it is necessary to distinguish IPV victims from those who experience IPV victimization only and those who experience both IPV victimization and perpetration.

The association between emotional and physical intimate partner violence and COVID-19 vaccine uptake in a community-based U.S. Cohort

Objective

To estimate risk of being unvaccinated against COVID-19 by experience of intimate partner violence (IPV).

Methods

Among 3,343 partnered individuals in a community-based U.S. cohort, we quantified emotional and physical IPV experienced between March and December 2020 and estimated risk of being unvaccinated against COVID-19 through June 2021 by experience of IPV. Experience of recent IPV was defined as endorsement of more frequent or severe IPV since the start of the pandemic or report of any past-month IPV in at least one of four follow-up surveys conducted by the end of December 2020. We created a three-level composite variable - no experience of IPV, experience of emotional but not physical IPV, and experience of physical IPV.

Results

Cisgender women, non-binary, or transgender individuals who reported experiencing emotional, but not physical, IPV and those who reported experiencing physical IPV were both at significantly higher risk of being unvaccinated for COVID-19 compared to those who reported experiencing no IPV (ARRemotional violence: 1.28 [95 % CI: 1.09 - 1.51]; ARRphysical violence: 1.70 [95 % CI: 1.41 - 2.05]). Cisgender men who reported experiencing physical IPV were also at significantly higher risk of being unvaccinated for COVID-19 (ARRphysical violence: 1.52 [95 % CI: 1.15 - 2.02]).

Conclusions

IPV may increase the risk of low vaccine uptake. Results highlight the need to incorporate IPV prevention and support into public health responses, with targeted resources and consideration for reducing barriers to public health interventions among those impacted.

Psychological Distress in Low-Income and Economically Marginalized Populations in India: Protective and Risk Factors

Studies at the juncture of development economics and public health take on considerable responsibility in addressing inequality and related mental health distress. Mental healthcare in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to the Kessler Psychological Distress Scale (K-10) with moderate distress in women (M = 26.30, SD = 9.15) and mild distress in men (M = 21.04, SD = 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and the level of education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews of the six women who scored the highest on the distress scale unveiled three master themes: (1) manifestation of psychological distress, (2) contextual challenges, and (3) sources of strength and resilience. Overall, participants reported a lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental healthcare.

The Long Shadow of Intimate Partner Violence: Associations of Mental and Physical Health With Employment, Housing, and Demographic Factors

Ongoing health issues influence the postseparation lives of survivors of intimate partner violence (IPV). This study identified associations between health following IPV and demographic, housing, employment, and social participation factors. Survivors of IPV in Australia were surveyed. Logistic regression assessed factors of interest with physical and mental health conditions. Six hundred and fifty-eight women participated. Physical health issues were associated with reduced skills and confidence in employment. A mental health diagnosis was associated with women not working as desired and lower incomes. Screening for health impacts and longer-term responses to women could reduce the long shadow of IPV impacts.

The Body in Crisis: A Health Needs Assessment among Female Survivors of Interpersonal Violence

BACKGROUND

When women who experience violence seek social services, they are looking to meet immediate needs: shelter, safety, and support. Seeking assistance as part of a crisis may inadvertently detract attention away from other critical needs. Literature illustrates the emotional and physical effects of violence on women's bodies, as well as their long-term health. While health may present as an urgent need in cases of serious injury, it is often overlooked in crisis-oriented service delivery systems. This study explored the experience with violence, health status, and holistic healthcare needs among women accessing interpersonal violence services in Texas.

METHODS

A tablet-based survey was conducted at a family justice center, rape crisis center, and emergency shelter among women (N = 99) in Fort Worth, Texas. Survey questions assessed the participants' demographic information, health status, health needs, healthcare utilization, barriers to accessing healthcare, and experience with interpersonal violence among participating women.

RESULTS

Two-thirds of the sample reported suffering injuries from victimization experiences. More than half of the sample (62%) reported they went to the emergency room at least one time in the last 6 months, with 11 women reported staying five or more nights in the hospital in the last 6 months. Participants described urgent (e.g., advised by healthcare provider, too serious for a clinic) and non-urgent (e.g., not having another source of care, closest provider) reasons for using the emergency room. Roughly, half of the sample (50%) reported having at least three chronic conditions.

DISCUSSION

This study illustrated that women seeking interpersonal violence related (IPV) services have multiple unmet needs and lack adequate access to physical and mental health care. Since the majority of the sample was living in poverty, there are multiple costs and investments in the participants' health that were forgone for their survival. This study provides data in support of the development of health-related services for IPV survivors.

Facilitators of Formal Help-Seeking for Adult Survivors of IPV in the United States: A Systematic Review

A survivor's decision to engage with formal services for experiences of intimate partner violence (IPV) is influenced by factors at the individual, interpersonal, and sociocultural levels. Understanding factors that facilitate survivors' choice to seek services could be beneficial to formal service providers including community agencies, health professionals, and the criminal justice system, providing guidance toward the development and implementation of accessible services for survivors of IPV. This systematic review of the literature aims to identify key factors that facilitate survivors' formal help-seeking. Ten electronic databases were searched for key terms related to help-seeking from formal services and facilitators of formal help-seeking. Articles were included in the review if the studies were conducted in the United States, focused on adults with experiences of IPV, and discussed facilitators of formal help-seeking. A total of 1,155 studies were initially identified, and after screening, 24 were included in the review. Seven factors were identified including provider knowledge, support, accessibility, desire to provide protection and to prevent future violence, and other factors such as knoweldge of and desire for services, policy factors, and personal factors. Findings demonstrate a need for more research on the facilitators of help-seeking among East Asian, South Asian, and Middle Eastern survivors living in the United States, as well as male-identified, trans, and gender nonconforming survivors. The review also indicates a need for culturally sensitive and accessible services that support survivors and the importance of raising awareness of the services and resources available for survivors.

The Gendered Pathways Through Which Intimate Partner Violence Affects Health: Exploring the Role of Unmet Healthcare Needs

The aim of this study was to examine the relationships between intimate partner violence (IPV), gender, unmet healthcare needs, and health. Specifically, this study identified how unmet healthcare needs mediate the relationship between IPV and health, and how this mediation is moderated by gender. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) (N = 15,425), we first estimated ordinary least squares regression models to investigate the association between IPV and self-rated health. Then, we used structural equation models to examine how unmet healthcare needs mediate this relationship. Lastly, we conducted a moderated mediation model to investigate whether gender moderates these mediation patterns. The results of this study showed that experiencing IPV was associated with a decrease in self-rated health and an increase in the unmet need for medical care (but not in unmet need for routine health check-ups). Unmet need for medical care explained about one-quarter of the negative association between IPV and self-rated health. A moderated mediation model revealed that indirect effects of IPV on health via unmet medical care needs were more pronounced among victimized women than victimized men. This study filled knowledge gaps about the mechanisms underlying the association between IPV and poor health status. Unmet healthcare needs partially mediated the relationship between IPV victimization and health. This mechanism was more salient for the health of victimized women than victimized men. Interventions designed to improve the health of IPV victims may focus on addressing unmet healthcare needs and could be tailored according to the gender of patients.

Traumatic Brain Injury Screening and the Unmet Health Needs of Shelter-Seeking Women with Head Injuries Related to Intimate Partner Violence

Background: Unmet health needs of women with head injuries sustained by intimate partner violence (IPV) include risk of traumatic brain injury (TBI). The purpose of this evaluation was to explore the potential effectiveness of TBI screening as a health promotion strategy for shelter-seeking women with IPV head injuries. We wanted to learn if shelter-seeking women, willing to disclose IPV, would accept TBI screening if offered.

Methods: An extended version of the HELPS TBI screening tool and survey of daily symptoms and health needs were used to screen new residents of an urban shelter for women.

Results: The participants (N = 18) primarily were educated black women with one or more self-reported IPV-related head injury. Most participants (77.8%) had positive TBI screens for probable brain injury. The majority (88.8%) lived with one or more daily symptoms they did not have before sustaining a IPV head injury. The symptoms reported most frequently were depression (88.9%), anxiety (77.8%), and headache (66.7%). All participants had one or more unmet health need. Although most (77.8%) needed to see a primary care provider, mental health care was the most important health need identified.

Conclusions: TBI screening could be considered an effective health promotion strategy for IPV survivors if screening facilitates treatment for positive screens and other unmet health needs. Further research is needed to properly assess this.

Nurses', midwives' and students' knowledge, attitudes and practices related to domestic violence: A cross-sectional survey

AIMS

To measure registered nurses', registered midwives', and nursing and midwifery students' current levels of knowledge, attitude and practices related to intimate partner violence.

BACKGROUND

Nurses and midwives whether registered or students need to be confident and competent in identifying and responding to intimate partner violence.

DESIGN

A cross-sectional survey.

METHODS

Data were collected through online surveys using the Physician Readiness to Manage Intimate Partner Violence Survey. Descriptive and inferential statistics were used to analyse the data.

RESULTS

Nursing and midwifery students were less knowledgeable and prepared than nurses and midwives. Midwives had more positive attitudes compared with nurses towards women experiencing intimate partner violence.

CONCLUSIONS

Heath care institutions and regulatory bodies should provide resources and support to nursing and midwifery professionals. Personal experiences of domestic abuse and professional experience of supporting victims of domestic abuse/intimate partner violence affected practitioner's abilities to identify and manage intimate partner violence.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse and midwifery managers can ensure that clinical and organisational policies and protocols are revisited and updated regularly and that interdisciplinary collaboration is promoted and emphasized for prompt identification and management of intimate partner violence.

Survivors' Social Construction of Intimate Partner Violence in Cebu City, Philippines

Intimate partner violence (IPV) is a worldwide social issue perpetrated by intimate male partners against their wives. Studies on IPV have generated accurate comparative information since the 1993 World Conference on Human Rights and the Declaration on the Elimination of Violence Against Women to guide strategy and track progress in attempts to comprehend the IPV issues. In many attempts to understand violence against women, the social construction of IPV was not well documented in the literature. This article aims to explore IPV survivors' social construction of IPV by analyzing the experiential narratives of IPV survivors. To address the objective, this article used the phenomenological approach by examining the lived experiences of 15 IPV survivors. Our study finds that IPV made IPV survivors empowered, and with this social construction, survivors were able to overcome violence perpetrated by their intimate partners. The findings further proved that giving preferential attention to the needs of IPV victims could lead to victim empowerment, a factor needed in the elimination of violence against women and children in all forms. It is suggested for any intervention activities to (a) ultimately address the empowerment of individuals and (b) respond to the needs of individuals because what may work for one victim may not work for another.

Intimate partner violence, associations with perceived need for help and health care utilization: a population-based sample of women in Sweden

Aim: To assess the association between physical intimate partner violence (physical IPV) in the past 5 years, perceived need for help and primary health care utilization due to mental health problems in a general population-based sample of women in Sweden. Methods: We performed structured follow-up interviews with 616 women between 1995 and 2015. Associations between physical IPV in the past 5 years and (i) perceived need for help and (ii) primary health care utilization due to mental health problems, were estimated by logistic regression analyses with crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results: Of the women who had experienced physical IPV in the past 5 years, 45.1% perceived a need for help but refrained from seeking care. After adjusting for sociodemographic factors, exposure to physical IPV in the past 5 years remained associated with perceived need for help (OR 3.54; CI 1.77–7.11). After adjusting for sociodemographic factors, the association between exposure to physical IPV and primary health care utilization did not remain statistically significant. Conclusions: Women exposed to physical IPV were more likely to perceive the need for help compared with unexposed women. A large proportion of IPV-exposed women in the general population may refrain from seeking care although they perceive a need for help. Future studies need to investigate potential barriers to mental health care seeking among women exposed to IPV. Routine questioning about IPV should be implemented in primary health care with improved referral to available support services.

Nurses' knowledge, attitudes and preparedness to manage women with intimate partner violence

AIM

To investigate nurses' knowledge, attitudes and practices related to intimate partner violence among women in Saudi Arabian healthcare settings.

BACKGROUND

There is a global focus on abuse experiences in clinical settings. However, nurses' practice in managing intimate partner violence patients in Saudi healthcare settings has not yet been examined.

INTRODUCTION

Intimate partner violence is a health issue that can lead to mortality and morbidity. It has recently received attention in an Arabian context. Thus, scrutinizing nurses' role in responding to intimate partner violence patients is needed to fill a current gap.

METHODS

A cross-sectional study was conducted with a convenience sample of 114 nurses from two hospitals in Saudi Arabia using a questionnaire.

RESULTS

Minimal previous intimate partner violence training was reported, as 63% of nurses had not received training related to intimate partner violence, and 52% believed that they did not receive adequate training to respond to intimate partner violence survivors. The results show that nurses had both low perceived knowledge and low preparedness in managing intimate partner violence, and only had basic intimate partner violence knowledge. Results indicated that nurses did not have appropriate attitudes towards intimate partner violence. The majority were not aware about intimate partner violence protocols or policies in their institutions. Only 2.6% had diagnosed intimate partner violence in the last six months.

CONCLUSION

There were gaps in nurses' perceived preparedness, knowledge, attitudes and behaviours. There was also limited training and preparation for nurses to assess and address intimate partner violence.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The study suggests the need for clear institutional health policies related to detecting, responding to, and preventing intimate partner violence. Guidelines about integrating intimate partner violence in nursing curricula and implementing in-service training should be developed and implemented. A multi-level intervention that enables nurses to respond to intimate partner violence is also needed.