'It is a hard decision': a qualitative study of perinatal intimate partner violence disclosure.
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ABSTRACT: Background
Perinatal intimate partner violence is a hidden under reported and difficult to identify problem which has negative effects on mother and child. The present study aimed to explore barriers and facilitators of perinatal intimate partner violence disclosure.Methods
This qualitative study was carried out from October 2019 to January 2021 in Mashhad, Iran. Participants included 23 abused women (11 pregnant and 12 after birth) which were selected via purposive sampling. Semi-structured in-depth interviews and focus group discussion were conducted until the data saturation was achieved. The data analysis was performed based on conventional content analysis adopted by Graneheim & Lundman.Results
The main themes "barriers to disclosure" and "facilitators of disclosure" were emerged as the result of data analysis. Barriers to disclosure included negative disclosure consequences and protection of family privacy. Facilitators of disclosure included maternal self-efficacy, threats to security, and formal and informal supportive networks.Conclusions
Most abused women did not disclose violence despite routine screening for perinatal intimate partner violence in antenatal care. Recognizing the barriers to and facilitators of violence disclosure play an important role in eliminating barriers, strengthening facilitators, providing effective supportive services for abused women, and reducing perinatal violence. Focus on the barriers to and the facilitators of disclosure will be useful to policymakers, health program planners, and health care providers to identify and manage intimate partner violence, appropriately.
SUBMITTER: Amel Barez M
PROVIDER: S-EPMC9664727 | biostudies-literature | 2022 Nov
REPOSITORIES: biostudies-literature
Publications
'It is a hard decision': a qualitative study of perinatal intimate partner violence disclosure.
Amel Barez Malikeh M Mirzaii Najmabadi Khadijeh K Latifnejad Roudsari Robab R Mousavi Bazaz Mojtaba M Babazadeh Raheleh R
Reproductive health 20221114 1
<h4>Background</h4>Perinatal intimate partner violence is a hidden under reported and difficult to identify problem which has negative effects on mother and child. The present study aimed to explore barriers and facilitators of perinatal intimate partner violence disclosure.<h4>Methods</h4>This qualitative study was carried out from October 2019 to January 2021 in Mashhad, Iran. Participants included 23 abused women (11 pregnant and 12 after birth) which were selected via purposive sampling. Sem ...[more]
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Project description:At least half a million women are victims of intimate partner violence in the United States annually, resulting in substantial harm. However, the etiology of violence to intimate partners is not well understood. Witnessing such violence in childhood has been proposed as a principal cause of adulthood perpetration, yet it remains unknown whether the association between witnessing intimate partner violence and adulthood perpetration is causal.We conducted a propensity-score analysis of intimate partner violence perpetration to determine whether childhood witnessing is associated with perpetration in adulthood, independent of a wide range of potential confounding variables, and therefore might be a causal factor. We used data from 14,564 U.S. men ages 20 and older from the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions.Nearly 4% of men reported violent behavior toward an intimate partner in the past year. In unadjusted models, we found a strong association between childhood witnessing of intimate partner violence and adulthood perpetration (for witnessing any intimate partner violence, risk ratio [RR] = 2.6 [95% confidence interval = 2.1-3.2]; for witnessing frequent or serious violence, 3.0 [2.3-3.9]). In propensity-score models, the association was substantially attenuated (for witnessing any intimate partner violence, adjusted RR = 1.6 [1.2-2.0]; for witnessing frequent or serious violence, 1.6 [1.2-2.3]).Men who witness intimate partner violence in childhood are more likely to commit such acts in adulthood, compared with men who are otherwise similar with respect to a large range of potential confounders. Etiological models of intimate partner violence perpetration should consider a constellation of childhood factors.
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Project description:BackgroundIntimate partner violence increases the risk of detrimental health, behaviors and psychological issues in mothers, affecting infant nutrition and development. However, the potential effects of maternal exposure to intimate partner violence on breastfeeding practices are understudied, and the results of individual studies are inconsistent and conflicting. The aims of this systematic review and meta-analysis are therefore to 1) estimate the prevalence of perinatal intimate partner violence and, 2) examine the relationship between perinatal intimate partner violence and breastfeeding outcomes.Methods and analysisThis systematic review and meta-analysis will investigate the association between perinatal intimate partner violence and breastfeeding outcomes, including early initiation within 1 hour after giving birth, exclusive breastfeeding under six months, and continued breastfeeding at two years or beyond. Comprehensive searches will be conducted in PsycInfo, Scopus, Web of Science, Medline, Cochrane, JBI EBP, CINAHL, Informit, and PubMed electronic databases. Data extraction will be performed independently by two reviewers, with discrepancies resolved by a third reviewer. Statistical analysis will be conducted using STATA/SE version 17, employing random-effects models to calculate pooled effect sizes and assess heterogeneity with I2 and Chi-square tests. Subgroup analyses and meta-regression will explore potential sources of heterogeneity.Discussion and conclusionEvidence suggests that intimate partner violence is linked to poor breastfeeding outcomes. This systematic review and meta-analysis will update, compile, and critically review the evidence of the role of intimate partner violence on breastfeeding outcomes. This systematic review and meta-analysis will also inform effective strategies and interventions to support breastfeeding among IPV-affected women, thereby enhancing maternal and child health.Ethics and disseminationAs this review and meta-analysis involves secondary analysis of existing data, ethical approval is not required. Findings will be disseminated through peer-reviewed publications and scientific conferences, aiming to inform strategies to support breastfeeding among women affected by intimate partner violence.Study registrationThis protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42024555048.
| S-EPMC11801569 | biostudies-literature
Project description:BackgroundWomen veterans, compared to civilian women, are especially at risk of experiencing intimate partner violence (IPV), pointing to the critical need for IPV screening and intervention in the Veterans Health Administration (VHA). However, implementing paper-based IPV screening and intervention in the VHA has revealed substantial barriers, including health care providers' inadequate IPV training, competing demands, time constraints, and discomfort addressing IPV and making decisions about the appropriate type or level of intervention.ObjectiveThis study aimed to address IPV screening implementation barriers and hence developed and tested a novel IPV clinical decision support (CDS) tool for physicians in the Women's Health Clinic (WHC), a primary care clinic within the Veterans Affairs Palo Alto Health Care System. This tool provides intelligent, evidence-based, step-by-step guidance on how to conduct IPV screening and intervention.MethodsInformed by existing CDS development frameworks, developing the IPV CDS tool prototype involved six steps: (1) identifying the scope of the tool, (2) identifying IPV screening and intervention content, (3) incorporating IPV-related VHA and clinic resources, (4) identifying the tool's components, (5) designing the tool, and (6) conducting initial tool revisions. We obtained preliminary physician feedback on user experience and clinical utility of the CDS tool via the System Usability Scale (SUS) and semistructured interviews with 6 WHC physicians. SUS scores were examined using descriptive statistics. Interviews were analyzed using rapid qualitative analysis to extract actionable feedback to inform design updates and improvements.ResultsThis study includes a detailed description of the IPV CDS tool. Findings indicated that the tool was generally well received by physicians, who indicated good tool usability (SUS score: mean 77.5, SD 12.75). They found the tool clinically useful, needed in their practice, and feasible to implement in primary care. They emphasized that it increased their confidence in managing patients reporting IPV but expressed concerns regarding its length, workflow integration, flexibility, and specificity of information. Several physicians, for example, found the tool too time consuming when encountering patients at high risk; they suggested multiple uses of the tool (eg, an educational tool for less-experienced health care providers and a checklist for more-experienced health care providers) and including more detailed information (eg, a list of local shelters).ConclusionsPhysician feedback on the IPV CDS tool is encouraging and will be used to improve the tool. This study offers an example of an IPV CDS tool that clinics can adapt to potentially enhance the quality and efficiency of their IPV screening and intervention process. Additional research is needed to determine the tool's clinical utility in improving IPV screening and intervention rates and patient outcomes (eg, increased patient safety, reduced IPV risk, and increased referrals to mental health treatment).
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