In their own words: Perspectives of IPV survivors on obtaining support within the healthcare system.

Autor: Hargrave AS; Department of Internal Medicine, University of California San Francisco (UCSF), San Francisco, California, United States of America.; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco (UCSF), San Francisco, California, United States of America., Dawson-Rose C; Department of Community Health Systems, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, United States of America., Schillinger D; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco (UCSF), San Francisco, California, United States of America.; Division of General Internal Medicine, Center for Vulnerable Populations, University of California San Francisco (UCSF), San Francisco, California, United States of America.; UCSF Institute for Health Policy Studies, University of California San Francisco (UCSF), San Francisco, California, United States of America., Ng F; Department of Internal Medicine, University of California San Francisco (UCSF), San Francisco, California, United States of America., Valdez J; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco (UCSF), San Francisco, California, United States of America., Rodriguez A; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco (UCSF), San Francisco, California, United States of America., Cuca YP; Department of Community Health Systems, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, United States of America., Bakken EH; Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America., Kimberg L; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco (UCSF), San Francisco, California, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Sep 06; Vol. 19 (9), pp. e0310043. Date of Electronic Publication: 2024 Sep 06 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0310043
Abstrakt: Background: Almost half of all women in the US experience intimate partner violence (IPV) in their lifetime. The US Preventive Services Task Force recommends IPV screening paired with intervention for women of reproductive age. We aim to understand clinical practices and policies that are beneficial, detrimental, or insufficient to support survivors of IPV in a safety-net healthcare system.
Methods: We sampled 45 women who were 18-64 years old, had experienced IPV within the prior year and were patients in the San Francisco Health Network. We conducted in-depth, semi-structured interviews to elicit their perspectives on disclosing IPV and obtaining support within the healthcare system. We analyzed our data using thematic analysis and grounded theory practices informed by ecological systems theory.
Findings: We identified four themes regarding factors that impeded or facilitated discussing and addressing IPV across interpersonal and systemic levels relating to relationship-building, respect, autonomy and resources. (1) Interpersonal barriers included insufficient attention to relationship-building, lack of respect or concern for survivor circumstances, and feeling pressured to disclose IPV or to comply with clinicians' recommended interventions. (2) Interpersonal facilitators consisted of patient-centered IPV inquiry, attentive listening, strength-based counseling and transparency regarding confidentiality. (3) Systemic barriers such as visit time limitations, clinician turn-over and feared loss of autonomy from involvement of governmental systems leading to separation from children or harm to partners, negatively affected interpersonal dynamics. (4) Systemic facilitators involved provision of resources through IPV universal education, on-site access to IPV services, and community partnerships.
Conclusions: Women experiencing IPV in our study reported that relationship-building, respect, autonomy, and IPV-related resources were essential components to providing support, promoting safety, and enabling healing in the healthcare setting. Successful trauma-informed transformation of healthcare systems must optimize interpersonal and systemic factors that improve survivor wellbeing while eliminating barriers.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Databáze: MEDLINE
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