Development and validation of Malaysian one stop crisis center service quality instrument (OSCC-Qual) for domestic violence management

One Stop Crisis Center (OSCC) is a multi-sectorial center aimed to provide medical, social, legal, police and shelter services to survivors of domestic violence, rape, sexual assault, sodomy and child abuse. Although OSCCs have been established for almost three decades in different parts of the world including in Malaysia, there is a lack of a validated instrument to measure the service quality rendered in OSCCs. A validated instrument known as OSCC-Qual was developed using a 5-stage approach where (1) in stage 1, group discussions were conducted among all authors to identify potential items for the instrument; (2) in stage 2, content validation was performed by 13 experts using content validity index and modified kappa; (3) in stage 3, exploratory factor analysis was performed by 141 healthcare staff with experience in managing OSCC cases to validate the items as well as to identify the number of factors in the instrument; (4) in stage 4, confirmatory factor analysis was performed by 110 domestic violence survivors to ascertain the validity of the factors and items retained in stage 3 and (5) in stage 5, forward and backward translation into local Malay and Chinese languages was performed. Results: In stage 1, a total of 42 items were identified. No item was deleted in stage 2. In stage 3, a total of 7 factors (i.e., "information provision", "competency of staff", "professionalism", "supportive environment", "attitude of staff", "multi-sectorial coordination" and "tangibles") were identified. Four items were deleted due to poor factor loading. In stage 4, another 3 items were iteratively removed due to poor factor loading. Discriminant validity was good. Conclusion: With the availability of the 7-factor and 35-item OSCC-Qual instrument, it is hoped that the efficiency of OSCC in achieving its philosophical objectives after three decades of implementation can be unraveled and remedial actions can be taken, if necessary.

Understanding what shapes the priorities of women who are mothering in the context of intimate partner violence: A qualitative study

AIM

To explore the priorities of women mothering children in the context of intimate partner violence and to understand what shapes those priorities.

DESIGN

A qualitative study using interpretive description, informed by Feminist Intersectionality adhering to the COREQ guidelines.

METHODS

Thematic analysis was used to analyse the data.

DATA SOURCES

Dialogic, semi-structured interviews were conducted with a community sample of 20 adult Canadian women who were mothering dependent children (under 18 years) in the context of recent intimate partner violence from a current or former partner.

RESULTS

Women's main priorities focused on their own and their children's well-being and creating stability related to housing and finances. Three themes identified: it's all about the kids; my safety…totally disregarded; and I have to take care of him. Multiple external factors (coercive control, structural inequities, assumptions about mothering) shape priorities and the tensions arising from competing priorities women felt compelled to address simultaneously.

CONCLUSION

Priorities of women mothering in the context of intimate partner violence are complex, shaped not only by what they want but by the limited options available to them given constraints such as income, employment, housing and service responses. Coercive control, structural inequities and assumptions about mothering are important factors influencing mothers' priorities and experiences. Better understanding mothers' priorities can support better tailored policies, services and nursing practice.

IMPLICATIONS FOR NURSING

Structural inequities that negatively impact health and well-being by limiting access to resources and the supports needed to enhance health can be better recognized and addressed through a trauma and violence informed care approach.

IMPACT

This study addressed understanding the priorities of women mothering in the context of intimate partner violence. This research will impact women mothering in the context of intimate partner violence who receive care from nurses and other providers as well as those who provide care.

REPORTING METHOD

This study adhered to relevant EQUATOR guidelines (the COREQ checklist).

NO PATIENT OR PUBLIC CONTRIBUTION

The women who took part in the interviews for this study did not participate in the study design, analysis or manuscript preparation.

Support or Betrayal? Swedish Survivors' Experiences of Support From Social Workers During Post-Separation Violence

The aim of this study is to shed light on how Swedish female survivors of male intimate partner violence experience support from social workers during post-separation violence. This is explored through an interview study with sixteen survivors. Hester's three planet model is utilized in the analysis. The results show that while the survivors described positive experiences of support from social workers on the Domestic violence planet, they felt social workers in the family law system on the Child contact planet enabled post-separation violence, and reported that this contributed to them feeling betrayed rather than supported.

Incredible Women: Legal Systems Abuse, Coercive Control, and the Credibility of Victim-Survivors

Research has long demonstrated that victim-survivors of intimate partner violence face barriers to being believed when they seek help via the legal system and are simultaneously at risk of their abuser weaponizing the legal system against them. This article draws on the experiences of 54 women victim-survivors of coercive control in Australia who had experienced legal systems abuse within criminal and civil protection order systems. Drawing on feminist legal theory, we highlight that the legal system continues to disbelieve women and validate abusers. These experiences hold implications for victim-survivor views on the merits and risks of criminalizing coercive control.

Structural Problems Demand Structural Solutions: Addressing Domestic and Family Violence

Despite the global recognition of domestic and family violence (DFV) as an outcome of unequal power relations between men and women, dominant frameworks for addressing DFV do not target the structural nature of the problem. Drawing on research conducted in partnership with the Federation of Community Legal Centres in Australia, we argue that a distinction needs to be made between what is genuinely structural change and what is system reform. Using intersectional feminist and decolonial theory and praxis, we reflect on what a structural approach to DFV could look like: one that confronts and actively tries to change the structural conditions that give rise to women's individual and collective vulnerability and victimization.

'Family court…sucks out your soul': Australian general practitioners' experiences supporting domestic violence survivors through family court

BACKGROUND

Domestic violence is a significant public health issue with survivors experiencing short- and long-term physical, sexual and psychological health issues. Given this, survivors of domestic violence use healthcare services at an increased rate compared to the general population. Therefore, general practitioners (GPs) are well placed to support survivors of domestic violence. However, many practitioners do not feel ready to address this complex issue of domestic violence. Further, there is no research exploring GPs' role in supporting families through family court in the context of domestic violence.

METHODS

This study used qualitative methods. Fifteen GPs participated in individual in-depth interviews. The interviews were audio recorded with consent, transcribed verbatim and thematically analysed.

RESULTS

The majority of participants were female GPs working in metropolitan settings. Four themes were generated from the data: on different planets, witnessing legal systems abuse, weaponizing mental health in family court and swinging allegiances. Participants had negative perceptions of family court and felt that it operated on a different paradigm to that of general practice which caused difficulties when supporting patients. Participants supported survivors through instances where the court was used by perpetrators to further their abusive behaviour or where the court acted abusively against survivors. In particular, perpetrators and the family court used survivors' mental health against them in court proceedings, which resulted in survivors being reluctant to receive treatment for their mental health. Participants struggled with their allegiances within their patient family and usually opted to support either the mother, the father, or the children.

CONCLUSIONS

Implications of these findings for GP training are evident, including curriculum that discusses the intersection of mental health diagnoses and legal proceedings. There may also be a place for health justice partnerships within general practice.

Post-separation abuse: A concept analysis

AIM

To report an analysis of the concept of post-separation abuse and its impact on the health of children and adult survivors.

DESIGN

Concept analysis.

DATA SOURCES

A literature search was conducted via PubMed, Cochrane and Embase and identified articles published from 1987 to 2021.

METHODS

Walker and Avant's (2019) eight stage methodology was used for this concept analysis, including identifying the concept, determining the purpose of analysis, identifying uses of the concept, defining attributes, identifying a model case and contrary case, antecedents and consequences and defining empirical referents.

RESULTS

Post-separation abuse can be defined as the ongoing, willful pattern of intimidation of a former intimate partner including legal abuse, economic abuse, threats and endangerment to children, isolation and discrediting and harassment and stalking. An analysis of literature identified essential attributes including fear and intimidation; domination, power and control; intrusion and entrapment; omnipresence; and manipulation of systems. Antecedents to post-separation abuse include patriarchal norms, physical separation, children, spatiality and availability, pre-separation IPV and coercive control and perpetrator characteristics. Consequences include lethality, adverse health consequences, institutional violence and betrayal, such as loss of child custody and economic deprivation.

CONCLUSION

This concept analysis provides a significant contribution to the literature because it advances the science for understanding the phenomenon of post-separation abuse. It will aid in developing risk assessment tools and interventions to improve standards of care for adult and children survivors following separation from an abusive partner.

IMPACT

This concept analysis of post-separation abuse provides a comprehensive insight into the phenomenon and a theoretical foundation to inform instrument development, future research and intervention. Post-separation abuse is a complex, multi-faceted phenomenon that requires differential social, legal and healthcare systems responses to support the health and well-being of survivors and their children.

Understanding Formal Responses to Intimate Partner Violence and Women's Resistance Processes: A Scoping Review

Intimate partner violence (IPV) literature addresses the ways in which women oppose violent male partners through acts of "everyday resistance." There is a limited understanding, however, of the relationship between women's resistance and their formal help-seeking in the context of IPV. Our scoping review, which includes 74 articles published in English-language journals between 1994 and 2017, attempts to help fill this gap by developing systematic knowledge regarding the following research questions: (1) How are formal institutional responses discussed within the literature on resistance to IPV? (2) How does institutional help-seeking facilitate or obstruct IPV survivors' personal efforts to resist violence? We find that institutions and organizations succeed in facilitating resistance processes when they counter victim-blaming ideas and provide IPV survivors with shared community and a sense of control over their futures. However, they fall short in terms of helping survivors by expecting survivors to adhere to a rigid narrative about appropriate responses to violence, devoting insufficient attention to individual-level factors impacting survivors' vulnerability and ability to access help, and replicating abuse dynamics when interacting with survivors. Policy and practice implications are discussed.

Missing Stories: Women with Physical Disabilities' Navigation and Responses to Domestic and Family Violence

There is significant global evidence that highlights both the high rates of domestic and family violence (DFV) for women with disabilities and the challenges they can face when navigating and responding to DFV. The purpose of this study was to understand women with physical disabilities' experiences of help-seeking when they did not access generalist DFV services. Presented are the participants' lived experiences of navigating and responding to DFV. Key findings include how participants resisted ableism, challenged assumptions about passivity, and the impacts of this resistance on their navigation of DFV.

Who's Going to Keep Us Safe? Surviving Domestic Violence and Shared Parenting During Covid-19

This paper discusses the experiences during COVID-19 of mothers who have young children, are survivors of domestic violence and who share parenting to highlight the further unsafe situations survivors of violence and their children were placed in during the pandemic. Part of a larger mixed methods study, these participants (n = 19) from three Canadian provinces, Alberta, Manitoba and Ontario, engaged in virtual individual one-on-one interviews via zoom. Using thematic analysis, four themes emerged from the data: 1) increased use of coercive controlling behaviors; 2) fear of the unknown; 3) lack of supports; and, 4) finding balance. Direct quotes are used to highlight the meaning of each theme. We outline the challenges these women have that are in addition to those experienced by many during COVID-19 times (increased stress, isolation, disconnect from supports, financial challenges). These include managing the shared parenting arrangements with a former abusive partner who used the pandemic as a further opportunity for coercive controlling behaviors under the guise of the public health order. The mothers were left to manage the difficult exchanges with a former abusive partner and unknown circumstances of the pandemic without guidance and support from legal actors. There will need to be a prioritization of the safety of mothers and their children in post-divorce parenting arrangements both during times of a community lockdown such as during the pandemic and also during non-pandemic times.

Psychosocial Separation and Women's Disengagement From Prosecutions Against Abusive Intimate Partners in Spain

In order to end and "liberate" themselves from an abusive relationship, female survivors of intimate partner violence (IPV) usually face a complex process. Although women may decide to seek help through the criminal justice system, some refuse to participate in legal proceedings against their abusers. While many studies have focused on exploring variables explaining disengagement from legal proceedings, the aim of this article is to study the impact of the process of liberation from an abusive relationship on the likelihood of disengagement (LoD) from legal proceedings. Liberation was measured through the psychosocial separation overall score and the LoD was predicted by a logistic regression model developed in a previous study in Spain. A sample of 80 women involved in legal proceedings for IPV against their ex-partners in Andalusia (Spain) participated in this study. Exploratory analyses were conducted using ANOVA and Chi-square; multiple linear regression analyses were used to study the relationship between psychosocial separation and LoD. Results showed that victims who had higher psychosocial separation from their abusers were less likely to disengage from legal proceedings against the abuser. We discuss the results in terms of practical implications like detection of women's need for specific psychological support to ease a comprehensive recovery. Training programs for legal professionals and judges in the judicial arena should use the results of this study to increase professionals' understanding of IPV and survivors' decision-making processes. This would lead to a decrease in survivors' secondary victimization, as well as decrease the frustration of legal professionals when victims disengage from legal proceedings.

Vulnerability Factors among Women Victimized by Intimate Partner Violence and the Presence of Children

This study aimed to a) examine the presence of children in relation to victim vulnerability factors and assessed risk for intimate partner violence (IPV) re-victimization, and b) examine the police response, in terms of risk management, in IPV cases with and without children, respectively. Data from a sample of 1407 women who had reported IPV victimization to the Swedish police was analyzed. The material consisted of risk assessments conducted by the police using the Swedish version of the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER) checklist, as well as the recommended risk management strategies. A series of chi-square tests of independence revealed that women with and without children, respectively, displayed different vulnerability factors to different extents. Women with children expressed more extreme fear of the perpetrator and were more likely to have an unsafe living situation, whereas women without children displayed more inconsistent attitudes or behaviors and health problems. However, binary logistic regression analyses showed that the victim vulnerability factors that were most strongly associated with an elevated risk rating for IPV re-victimization were generally the same for both groups of victims. Finally, the presence of children was related to a higher risk rating for imminent IPV re-victimization and to recommendations of more than standard levels of risk management strategies. The results indicate that the Swedish police consider the presence of children in relation to a victim's risk for re-victimization as well as in terms of recommended risk management strategies.

What is the role of firearms in nonfatal intimate partner violence? Findings from civil protective order case data

BACKGROUND

Perpetrators of intimate partner violence (IPV) use firearms to injure, scare, and manipulate their partners. Abusers who have a firearm in their homes are more likely to threaten and/or kill their partner. To date, however, limited research documents the nature of IPV perpetrator firearm access or the prevalence of nonfatal firearm abuse behaviors.

METHODS

Federal law restricts firearm access for IPV perpetrators in qualifying domestic violence protective order (DVPO) cases and information about firearms should be disclosed during the DVPO process. We used secondary data from civil DVPO cases (n = 406) in North Carolina that were collected using a representative sampling strategy. Data were from DVPO case files and structured DVPO hearing observations. We conducted a content analysis to record IPV perpetrator access to guns and reported firearm abuse behaviors. We used a linear regression analysis to determine whether IPV perpetrator gun access was associated with higher levels of reported abuse. We also examined factors associated with perpetration of nonfatal firearm abuse.

RESULTS

We found evidence of perpetrator firearm access in nearly half of all cases (46%, n = 108). Controlling for covariates, gun access was significantly associated with higher levels of reported IPV (b = 0.5, p < .001). Firearm abuse was reported in nearly one out of four cases (23.1%, n = 101), and often entailed spoken threats, displaying a gun, or holding a partner at gun point. The only factors associated with firearm abuse in the multivariate models were related to English language speaking/fluency.

CONCLUSIONS

Gun access should be considered an indicator for severe IPV. We must ensure that existing legal mechanisms to identify and restrict abuser access to firearms are fully implemented and enforced. Firearm abuse often manifests as non-physical coercive control which is traumatic and has the potential to escalate to homicide, even in the absence of past physical violence.

"The System Had Choked Me Too": Abused Mothers' Perceptions of the Custody Determination Process That Resulted in Negative Custody Outcomes

Intimate partner violence (IPV) is a public health problem that continues to affect abused mothers after separation from an abusive partner. In addition to the risk of ongoing control and violence by abusers, the custody determination process may present challenges for mothers who end up with negative custody outcomes (e.g., share custody with abusers or lose custody). Using constructivist grounded theory techniques, we conducted a qualitative analysis of interviews with 24 abused mothers with negative custody outcomes to understand how they perceive and make sense of the process as a whole, and how they cope with these outcomes. The custody determination process was reportedly complex and stressful, and most mothers did not anticipate a negative custody outcome. Mothers' perceptions and experiences followed three phases: "trusting "the system" to protect them and their children, adapting to "the system" in search of positive outcomes, and, once custody decisions were determined, coping with the aftermath of the judicial system process, either by accepting or resisting the outcome. This study echoes previous calls for further training and policies that make the custody determination process less burdensome and harmful for survivors and their children.

Mediating Justice: Women's Perceptions of Fairness in the Civil Protection Order Process

Mediation use has grown rapidly in the past few decades as an efficacious method of civil dispute resolution. However, early research suggests that civil mediation may cause further harm to victims of intimate partner abuse because, based on the inherent power dynamics of abusive relationships, they are not able to effectively advocate on their own behalf. In addition, organizational efficiency concerns have led to the development of consent processes for civil protection orders (POs). However, research has yet to examine the extent to which victims of intimate partner violence who take part in these consent processes perceive the process and associated outcomes as fair. Using qualitative data (N = 19 interviews) collected from women who sought civil POs through Family Court in Delaware, this research finds that the consent process and women's interactions with mediators reproduce power inequalities that are inherent in cases of intimate partner abuse, which shape their perceptions of fairness in the PO process and outcomes. Victims being silenced and disempowered throughout the consent process results in cumulative effects-similar tactics used by batterers-which continue to leave victims vulnerable. In addition, the power asymmetry victims experience in abusive relationships is replicated by the legal institution and court structure in terms of not having access to attorneys, not receiving guidance and advocacy, and, at times, experiencing insensitive treatment. Thus, this study provides insight into the inequalities present within the PO consent process that can create further harm to victims.

The Use of Structural Intersectionality as a Method to Analyze How the Domestic Violence Civil Protective Order Process Replicates Inequality

While protective orders remain a commonly used resource, multiply marginalized survivors are often unable to file for, obtain, serve, and enforce orders. I argue that using structural intersectionality as a method is the best way to reveal how the protective order process replicates broader social inequalities. I advocate for an alternative way of using structural intersectionality. I first identify the mechanisms by which inequalities exist and then describe how these can be traced back to intersecting social identities. In doing so, I highlight the importance of historical context and the blurring of the civil and criminal legal systems.

Intimate Partner Violence Experienced by Physicians

PURPOSE

World Health Organization (WHO) defines intimate partner violence (IPV) as physical, sexual or psychological harm caused by an intimate partner or ex-partner. There are few studies describing interpersonal violence (IPV) among physicians. Our study describes IPV experienced by U.S. physicians.

METHODS

This was a multicenter survey administered to 4 physician groups in 2015 to 2016. In total 400 respondents returned survey results. Measures included current IPV, childhood abuse, mental health, professional role, and demographics.

RESULTS

IPV was reported by 24% of respondents. The most frequent abuses reported were: verbal (15%), physical (8%) followed by sexual abuse (4%) and stalking (4%). Logistic regression model found that IPV was more likely to be reported by older participants (aged 66-89), those who experienced childhood abuse, working less than full time, and had been diagnosed with a personality disorder. Women and Asian Americans reported slightly higher IPV rates.

CONCLUSIONS

Our study has implications for both medical education and intervention development. Universal screening and education that addresses clinical implications when treating peers who experience IPV are needed. Workplace interventions that consider unique physician characteristics and experiences are needed, as well as programs that support sustained recovery. This is the first survey to our knowledge that confirms that physicians experience IPV at a rate consistent or higher than the national level. We developed a standardized instrument to assess IPV in male and female physicians at various career stages. We also identified significant predictors that should be included in IPV screening of potential physician victims.

Predicting Disengagement from Judicial Proceedings by Female Victims of Intimate Partner Violence in Spain: A Systematic Replication With Prospective Data

This article examines which variables predict disengagement from legal proceedings by victims of intimate partner violence in the first steps of the Spanish judicial process. We replicated a previous retrospective study with a prospective sample of 393 women. The relationships of sociodemographic, emotional, motivational, and psychological variables with procedural withdrawals were analyzed. We developed a binary logistic regression model that predicts disengagement with two variables: the contact with the abuser and the interaction between this contact and the thought of going back with him. Interesting differences between the current and the retrospective study were found. Results are discussed extensively in the conclusions.

Parental alienation, coaching and the best interests of the child: Allegations of child sexual abuse in the Family Court of Australia

BACKGROUND

Allegations of child sexual abuse provide complex challenges to family court systems.

OBJECTIVES

Despite being highly criticised in the academic research, this analysis examined whether and how the gendered concepts of parental alienation syndrome or parental alienation more broadly are still being used to rebut allegations of child sexual abuse in family court cases in Australia. Parental Alienation is broadly understood as the deliberate actions of one parent to disrupt and prevent children's ongoing relationships with their other parent, in this case through allegations of abuse.

METHODS

We examined 357 publicly available judgements of the Family Court of Australia between 2010 and 2015. Judgements were analysed qualitatively for key themes using N-VIVO software.

RESULTS

Five themes emerged in the data, including use of the concept of parental alienation, coaching, mothers as manipulative, mothers as mentally ill, and impact of the best interest of the child.

CONCLUSIONS

Results indicate that judgements made in the Family Court of Australia are both similar and divergent from those made in other jurisdictions internationally. The complexity of responding to allegations of child sexual abuse for parents is discussed.

The medicolegal, psycho-criminological, and epidemiological reality of intimate partner and non-intimate partner femicide in North-West Italy: looking backwards to see forwards

This paper addresses femicide in Italy. The assumption is that femicide is not a discrete act of killing a woman. It is assumed that depending on the types of relationship between the victim and the perpetrator (e.g., known versus unknown, intimate versus acquaintance), the risk processes may differ. When femicide involves the killing of an intimate partner, it is likely to be characterized by sustained and escalating intimate partner violence (IPV) that can reach its climax with extreme acts of violence that lead to intimate partner femicide (IPF). Eighty-six cases of femicide that occurred in North-West Italy between 1993 and 2013 were examined in this study. Findings suggest that femicide was disproportionately perpetrated by intimate partners (current or past), rather than strangers. IPF was likely to be the epilogue of an abusive relationship, with high levels of contentiousness and conflicts being the frequent significant precursors. Non-intimate partner femicide (NPF) was more likely to be characterized by antisocial or predatory motives, highly frequent when the victims were prostitutes.These preliminary findings suggest that joint scientific, professional, and political efforts are paramount in order to address strategies aimed at assessing the differential risk of IPV early in time so as to prevent it from escalating into IPF or NPF and to provide the appropriate support for victims and their families.

Institutional Violence Against Users of the Family Law Courts and the Legal Harassment Scale

The term harassment is often used to refer two contexts, the workplace and school, but not the legal system itself. Long drawn-out litigation in the Family Law Courts often produces a surreptitious phenomenon of violence toward one of the litigating parties, who become victims of the legal system itself. The aim of this study was to determine whether legal harassment could be detected and measured in the Spanish Justice System using an innovative Legal Harassment Scale (LHS). This hypothesis was substantiated by the data obtained using a new 32-item psychometric instrument with a global index: the LHS, consisting of four factors: Direct Aggression, Procedural Harassment, Personal Contempt, and Manipulation of Reality. The estimated reliability and validity of the LHS was satisfactory, both in terms of the global score, and for each of the four factors distributed along the normal curve. The results of this study are discussed in terms of the limitations of the study and in relation to future lines of research aimed at ensuring that the legal system respects and safeguards the rights of the parties involved in litigation, and that no party falls victim to legal harassment.