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Grand'Maison V. Resisting invisibility in healthcare responses to gender-based violence: a content analysis. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2024; 33:144-159. [PMID: 38803283 DOI: 10.1080/14461242.2024.2350510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/29/2024] [Indexed: 05/29/2024]
Abstract
Women and girls with disabilities are located at the intersections of patriarchal, ableist, and other structures of oppression that produce specific and heightened vulnerabilities to gender-based violence (GBV). Public health practitioners widely recognise the role of the healthcare sector in addressing GBV, however the role of the healthcare sector in addressing GBV must be questioned given ongoing barriers to healthcare access for people with disabilities. Grounded in an intersectional framework, I conducted a summative content analysis of GBV healthcare interventions to examine whether and how disability and intersectionality are mobilised in public health understanding of, and strategies to, address GBV. By bringing visibility to the ways in which silences construct and sustain the invisibility of women with disabilities and other social structures, I argue that GBV healthcare responses not only fail to provide care for women with disabilities across social locations, but they also risk reproducing understandings that devalue their lives.
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DeMaria AL, Meier S, King H, Sidorowicz H, Seigfried-Spellar KC, Schwab-Reese LM. The role of community healthcare professionals in discussing sexual assault experiences during obstetrics and gynecological healthcare appointments. BMC Womens Health 2023; 23:263. [PMID: 37189119 PMCID: PMC10184971 DOI: 10.1186/s12905-023-02401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/28/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Nearly half of adult women in the US report experiencing sexual assault, with almost one-fifth reporting rape. For many sexual assault survivors, healthcare professionals are the first point of contact and disclosure. This study aimed to understand how healthcare professionals working in community settings perceived their role in discussing sexual violence experiences with women during obstetrical and gynecological healthcare appointments. The secondary purpose was to compare healthcare professionals' perspectives with the patients' to determine how sexual violence conversations should occur in these environments. METHODS Data were collected in two phases. Phase 1 consisted of 6 focus groups (Sept-Dec, 2019) with women aged 18-45 (n = 22) living in Indiana who sought community-based or private healthcare for women's reproductive healthcare needs. Phase 2 included 20 key-informant interviews with non-physician healthcare professionals (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women's reproductive healthcare. Focus groups and interviews were audio-recorded, transcribed, and analyzed using thematic analyses. HyperRESEARCH assisted in data management and organization. RESULTS There were three resulting themes: (1) healthcare professionals' approaches to screening for a history of sexual violence varied depending on how they ask, what setting they work in, and type of professional asking; (2) healthcare experiences can compound traumatic experiences and create distrust with survivors; and (3) sexual violence impacts patient healthcare experiences through what services they seek, how professionals may interact with them, and what professionals they are willing to utilize. CONCLUSIONS Findings offered insight into actionable and practical strategies for enhancing sexual violence screening and discussions in community-based women's reproductive health settings. The findings offer strategies to address barriers and facilitators among community healthcare professionals and the people they serve. Incorporating healthcare professional and patient experiences and preferences for violence-related discussions during obstetrical and gynecological healthcare appointments can assist in violence prevention efforts, improve patient-professional rapport, and yield better health outcomes.
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Affiliation(s)
- Andrea L DeMaria
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA.
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA.
| | - Stephanie Meier
- Division of Consumer Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - Hannah King
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
| | - Haley Sidorowicz
- Department of Biological Sciences, College of Science, Purdue University, West Lafayette, IN, USA
| | - Kathryn C Seigfried-Spellar
- Department of Computer and Information Technology, Polytechnic Institute, Purdue University, West Lafayette, IN, USA
| | - Laura M Schwab-Reese
- Department of Public Health, College of Health and Human Sciences, Purdue University, 812 West State Street, 47907, West Lafayette, IN, USA
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Carman MJ, Kay-Lambkin F. Long-Term Recovery from Intimate Partner Violence: Recovery and Hope. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13825. [PMID: 36360705 PMCID: PMC9654800 DOI: 10.3390/ijerph192113825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Recovery is a preferred outcome for assessing intervention effectiveness in the context of intimate partner violence (IPV), but measurement tools are in nascent form. It is therefore unclear what the recovery potential of survivors may be. A national online survey explored the self-rated recovery progress of Australian women (n = 1116), using visual analog scales (VAS) for recovery, hope, and other demographic variables. Findings show that many women rated themselves as completely recovered (14% of the eligible sample and 22% of the women who had left their partner > 10 years previously). However, most women experienced recovery as an ongoing process of healing (81%) and some women made little recovery progress (5%). Nevertheless, 77% of women who had separated >10 years ago rated their recovery as significant (scores of >70/100). Surprisingly, hope and recovery scores were only moderately correlated. This requires further investigation to determine what impacts on hope in long-term recovery, and how subjective and objective measures of hope and recovery vary in the context of IPV. The VAS was an efficient unidimensional measure for an online survey and is proposed for use in clinical and service contexts requiring subjective measures.
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Affiliation(s)
- Mary Jean Carman
- School of Medicine and Public Health, College of Medicine, Health and Well-Being, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, College of Medicine, Health and Well-Being, University of Newcastle, Newcastle, NSW 2308, Australia
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
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Korab-Chandler E, Kyei-Onanjiri M, Cameron J, Hegarty K, Tarzia L. Women's experiences and expectations of intimate partner abuse identification in healthcare settings: a qualitative evidence synthesis. BMJ Open 2022; 12:e058582. [PMID: 35835525 PMCID: PMC9289017 DOI: 10.1136/bmjopen-2021-058582] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To explore women's experiences and expectations of intimate partner abuse (IPA) disclosure and identification in healthcare settings, focusing on the process of disclosure/identification rather than the healthcare responses that come afterwards. DESIGN Systematic review and meta-synthesis of qualitative studies DATA SOURCES: Relevant studies were sourced by using keywords to search the databases MEDLINE, EMBASE, CINAHL, PsychINFO, SocINDEX and ASSIA in September 2021. ELIGIBILITY CRITERIA Studies needed to focus on women's views about IPA disclosure and identification in healthcare settings, use qualitative methods and have been published in the last 5 years. DATA EXTRACTION AND SYNTHESIS Relevant data were extracted into a customised template. The Critical Appraisal Skills Programme checklist for qualitative research was used to assess the methodological quality of included studies. A thematic synthesis approach was applied to the data, and confidence in the findings was appraised using The Confidence in the Evidence from Reviews of Qualitative research methods. RESULTS Thirty-four studies were included from a range of healthcare settings and countries. Three key themes were generated through analysing their data: (1) Provide universal education, (2) Create a safe and supportive environment for disclosure and (3) It is about how you ask. Included papers were rated overall as being of moderate quality, and moderate-high confidence was placed in the review findings. CONCLUSIONS Women in the included studies articulated a desire to routinely receive information about IPA, lending support to a universal education approach that equips all women with an understanding of IPA and options for assistance, regardless of disclosure. Women's suggestions for how to promote an environment conducive to disclosure and how to enquire about IPA have clear implications for clinical practice.PROSPERO registration numberCRD42018091523.
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Affiliation(s)
| | - Minerva Kyei-Onanjiri
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jacqueline Cameron
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Laura Tarzia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
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Women Tell All: A Comparative Thematic Analysis of Women's Perspectives on Two Brief Counseling Interventions for Intimate Partner Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052513. [PMID: 35270204 PMCID: PMC8909494 DOI: 10.3390/ijerph19052513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/04/2022] [Accepted: 02/18/2022] [Indexed: 11/24/2022]
Abstract
Background: Intimate partner violence (IPV) is a significant public health problem that is commonly experienced by women and associated with psychosocial health issues. Recovering from IPV through Strengths and Empowerment (RISE) is a brief, clinician-administered, variable-length (1–6 sessions), modular, individualized psychosocial counseling intervention developed for women experiencing IPV. We present qualitative feedback and quantitative helpfulness ratings from women patients of the Veterans Health Administration who completed a randomized clinical trial (RCT) comparing RISE to a clinician-administered advocacy-based Enhanced Care as Usual (ECAU; a single structured session consisting of psychoeducation, safety-planning, resources, and referrals). Methods: 58 participants (Mage = 39.21) completed post-intervention semi-structured qualitative interviews, including helpfulness ratings, at two follow-up assessments (10- and 14-weeks post-enrollment) to assess the acceptability, usefulness, and perceived fit of the interventions for women’s needs. Interviews were transcribed and analyzed using a hybrid deductive-inductive analytic approach. Results: While both the RISE and ECAU interventions were deemed helpful (interventions were rated as ‘highly helpful’ by 77% of RISE and 52% of ECAU participants), differences were identified in perceived impacts of the intervention, application of content, approach to patient-centeredness, and implementation recommendations. Conclusions: Findings shed light on women Veterans’ experiences and preferences for IPV psychosocial counseling interventions. Such knowledge can inform evidence-based, trauma-informed, and individualized care for women Veterans who experience IPV and may have relevance to other populations of women who experience IPV.
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Actions Taken by Women in Response to Intimate Partner Violence and Intimate Partner Violence Status at 1-Year Follow-Up. Womens Health Issues 2020; 30:330-337. [PMID: 32513519 DOI: 10.1016/j.whi.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) is a pervasive public health issue with significant physical and mental health sequelae. A longer duration and greater severity of abuse are associated with adverse health outcomes and increased risk of revictimization. Current research has identified a variety of strategies used by women in response to abuse, but has not established whether the use of these strategies is associated with decreased IPV over time. For this study, we analyzed the associations between the use of specific actions in response to abuse-placating, resistance, informal or formal network help-seeking, safety planning, and substance use-and IPV victimization at the 1-year follow-up. METHODS Ninety-five women with past-year IPV at baseline participated in a 1-year follow-up survey measuring their use of specific actions in response to IPV and subsequent IPV status. IPV victimization at the 1-year follow-up was analyzed as a function of types of actions taken and sociodemographic variables. RESULTS Among women with past-year IPV at baseline (N = 95), 53% reported no further IPV victimization at the 1-year follow-up. In bivariate analysis, social support was associated with decreased risk of IPV victimization (odds ratio, 0.43; 95% confidence interval [CI], 0.18-0.99). In multivariable analyses, high use of placating (adjusted odds ratio, 9.40; 95% CI, 2.53-34.9), formal network help-seeking (adjusted odds ratio, 7.26; 95% CI, 1.97-26.74), and safety planning (adjusted odds ratio, 2.98; 95% CI, 1.02-8.69) strategies were associated with an increased risk of IPV victimization at the 1-year follow-up. CONCLUSIONS Our data demonstrate that IPV exposure can change over time and that the use of specific actions in response to IPV can be indicators of risk of subsequent victimization. Abuse severity is an important potential confounder of action efficacy.
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Sorrentino AE, Iverson KM, Tuepker A, True G, Cusack M, Newell S, Dichter ME. Mental health care in the context of intimate partner violence: Survivor perspectives. Psychol Serv 2020; 18:512-522. [PMID: 32237873 DOI: 10.1037/ser0000427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Experience of violence or abuse from an intimate partner (intimate partner violence, IPV) can result in a variety of psychological and mental health impacts for which survivors may seek psychotherapy or other mental health services. Individuals experiencing IPV may have specific needs and preferences related to mental health care, yet the question of how to best provide client-centered mental health care in the context of IPV has received little attention in the literature. In this article, we report on findings from qualitative interviews with 50 women reporting past-year IPV who received care through the Veterans Health Administration regarding experiences with and recommendations for mental health services. Participants described client-centered mental health care in the context of recent or ongoing IPV as being characterized by flexibility and responsiveness around discussion of IPV; respect for the complexity of clients' lives and support for self-determination; and promoting safety and access to internal and external resources for healthy coping. We discuss findings in terms of their implications for the mental health field, highlighting the need for flexibility in application of evidence-based treatments, improved coordination between therapeutic and advocacy services, and training to enhance competencies around understanding and responding to IPV. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Katherine M Iverson
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System
| | - Anaïs Tuepker
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System
| | - Gala True
- South Central Mental Illness, Research, Education, and Clinical Center, Southeast Louisiana Veterans Health Care System
| | - Meagan Cusack
- VA Center for Health Equity Research and Promotion, Crescenz VA Medical Center
| | - Summer Newell
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System
| | - Melissa E Dichter
- VA Center for Health Equity Research and Promotion, Crescenz VA Medical Center
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Gagliardi AR, Nyhof BB, Dunn S, Grace SL, Green C, Stewart DE, Wright FC. How is patient-centred care conceptualized in women's health: a scoping review. BMC WOMENS HEALTH 2019; 19:156. [PMID: 31822284 PMCID: PMC6902460 DOI: 10.1186/s12905-019-0852-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 11/15/2019] [Indexed: 12/25/2022]
Abstract
Background Gendered disparities in health care delivery and outcomes are an international problem. Patient-centred care (PCC) improves patient and health system outcomes, and is widely advocated to reduce inequities. The purpose of this study was to review published research for frameworks of patient-centred care for women (PCCW) that could serve as the basis for quality improvement. Methods A scoping review was conducted by searching MEDLINE, EMBASE, CINAHL, SCOPUS, Cochrane Library, and Joanna Briggs index for English-language quantitative or qualitative studies published from 2008 to 2018 that included at least 50% women aged 18 years or greater and employed or generated a PCCW framework. Findings were analyzed using a 6-domain PCC framework, and reported using summary statistics and narrative descriptions. Results A total of 9267 studies were identified, 6670 were unique, 6610 titles were excluded upon title/abstract screening, and 11 were deemed eligible from among 60 full-text articles reviewed. None were based on or generated a PCCW framework, included solely women, or analyzed or reported findings by gender. All studies explored or described PCC components through qualitative research or surveys. None of the studies addressed all 6 domains of an established PCC framework; however, additional PCC elements emerged in 9 of 11 studies including timely responses, flexible scheduling, and humanized management, meaning tailoring communication and treatment to individual needs and preferences. There were no differences in PCC domains between studies comprised primarily of women and other studies. Conclusions Given the paucity of research on PCCW, primary research is needed to generate knowledge about PCCW processes, facilitators, challenges, interventions and impacts, which may give rise to a PCCW framework that could be used to plan, deliver, evaluate and improve PCCW.
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Affiliation(s)
- Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13 EN-228, Toronto, ON, M5G2C4, Canada.
| | - Bryanna B Nyhof
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | | | - Sherry L Grace
- York University and University Health Network, Toronto, Canada
| | - Courtney Green
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada
| | - Donna E Stewart
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
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Danitz SB, Stirman SW, Grillo AR, Dichter ME, Driscoll M, Gerber MR, Gregor K, Hamilton AB, Iverson KM. When user-centered design meets implementation science: integrating provider perspectives in the development of an intimate partner violence intervention for women treated in the United States' largest integrated healthcare system. BMC Womens Health 2019; 19:145. [PMID: 31771557 PMCID: PMC6880505 DOI: 10.1186/s12905-019-0837-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 10/31/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against women is a global health problem that is a substantial source of human suffering. Within the United States (US), women veterans are at high risk for experiencing IPV. There is an urgent need for feasible, acceptable, and patient-centered IPV counseling interventions for the growing number of women treated in the US's largest integrated healthcare system, the Veterans Health Administration (VHA). Implementation science and user-centered-design (UCD) can play an important role in accelerating the research-to-practice pipeline. Recovering from IPV through Strengths and Empowerment (RISE) is a flexible, patient-centered, modular-based program that holds promise as a brief counseling intervention for women veterans treated in VHA. We utilized a UCD approach to develop and refine RISE (prior to formal effectiveness evaluations) by soliciting early feedback from the providers where the intervention will ultimately be implemented. The current study reports on the feedback from VHA providers that was used to tailor and refine RISE. METHOD We conducted and analyzed semi-structured, key-informant interviews with VHA providers working in clinics relevant to the delivery of IPV interventions (n = 23) at two large medical centers in the US. Participants' mean age was 42.6 years (SD = 11.6), they were predominately female (91.3%) and from a variety of relevant disciplines (39.1% psychologists, 21.7% social workers, 17.4% physicians, 8.7% registered nurses, 4.3% psychiatrists, 4.3% licensed marriage and family therapists, 4.3% peer specialists). We conducted rapid content analysis using a hybrid inductive-deductive approach. RESULTS Providers perceived RISE as highly acceptable and feasible, noting strengths including RISE's structure, patient-centered agenda, and facilitation of provider comfort in addressing IPV. Researchers identified themes related to content and context modifications, including requests for additional safety check-ins, structure for goal-setting, and suggestions for how to develop and implement RISE-specific trainings. CONCLUSIONS These findings have guided refinements to RISE prior to formal effectiveness testing in VHA. We discuss implications for the use of UCD in intervention development and refinement for interventions addressing IPV and other trauma in health care settings globally. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03261700; Date of registration: 8/25/2017, date of enrollment of first participant in trial: 10/22/2018. Unique Protocol ID: IIR 16-062.
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Affiliation(s)
- Sara B. Danitz
- Women’s Health Sciences Division of the National Center for PTSD (116B-3), VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130 USA
| | - Shannon Wiltsey Stirman
- Dissemination and Training Division of the National Center for PTSD, VA Palo Alto Healthcare System, Menlo Park, CA USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA USA
| | - Alessandra R. Grillo
- Women’s Health Sciences Division of the National Center for PTSD (116B-3), VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130 USA
| | - Melissa E. Dichter
- VA Center for Health Equity Research and Promotion (CHERP), Philadelphia, PA USA
- Temple University, School of Social Work, Philadelphia, PA USA
| | - Mary Driscoll
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME), VA Connecticut Healthcare System, West Haven, CT USA
- Yale School of Medicine, New Haven, CT USA
| | - Megan R. Gerber
- VA Boston Healthcare System, Boston, MA USA
- Boston University School of Medicine, Boston, MA USA
| | - Kristin Gregor
- VA Boston Healthcare System, Boston, MA USA
- Boston University School of Medicine, Boston, MA USA
| | - Alison B. Hamilton
- VA Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA USA
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA USA
| | - Katherine M. Iverson
- Women’s Health Sciences Division of the National Center for PTSD (116B-3), VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130 USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA USA
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Iverson KM, Dardis CM, Grillo AR, Galovski TE, Pogoda TK. Associations between traumatic brain injury from intimate partner violence and future psychosocial health risks in women. Compr Psychiatry 2019; 92:13-21. [PMID: 31203176 DOI: 10.1016/j.comppsych.2019.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/31/2019] [Accepted: 05/08/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE The effects of traumatic brain injury (TBI) incurred during military service are widely studied; however, less is known about TBI resulting from intimate partner violence ("IPV-related TBI"). Women Veterans are at high risk for IPV, yet no research has examined future psychosocial health risks associated with IPV-related TBI history in this population. METHODS We examined psychiatric and physical health outcomes, as well as IPV, in a sample of women Veterans who, at Time 1, reported IPV-related TBI with (n = 13) or without (n = 20) persistent symptoms; that is, symptoms such as memory problems, balance problems or dizziness, sensitivity to bright light, irritability, headaches, and sleep problems that began or got worse immediately following the IPV-related TBI and occurred within the past week. These women completed web-based surveys 18 months later (Time 2), which included validated measures of psychiatric and physical health symptoms as well as past-year IPV. We conducted linear regressions to model whether T1 IPV-related TBI with persistent symptoms predicted worse health outcomes at T2, in comparison to T1 IPV-related without persistent symptoms. RESULTS Controlling for significant covariates (i.e., military sexual trauma; MST), IPV-related TBI with persistent symptoms at Time 1 was associated with significantly worse outcomes at Time 2 across all health outcome domains (sr2 range: 0.12-0.37). After controlling for MST and probable posttraumatic stress disorder (PTSD) at Time 1, IPV-related TBI with persistent symptoms at Time 1 remained significantly associated with worse Time 2 symptoms of insomnia, depression, and physical health (sr2 range: 0.12-0.25). CONCLUSION Women who experience IPV-related TBI with persistent symptoms are at higher risk for worse psychosocial health outcomes 18 months later. Findings necessitate screening IPV survivors for TBI with persistent symptoms and tailoring TBI and psychosocial interventions to reduce risk for ongoing health sequelae.
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Affiliation(s)
- Katherine M Iverson
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, United States of America; Boston University School of Medicine, Boston, MA 02118, United States of America.
| | - Christina M Dardis
- Department of Psychology, Towson University, Towson, MD 21252, United States of America
| | - Alessandra R Grillo
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, United States of America
| | - Tara E Galovski
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA 02130, United States of America; Boston University School of Medicine, Boston, MA 02118, United States of America
| | - Terri K Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA 02130, United States of America; Boston University School of Public Health, Boston, MA 02118, United States of America
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