The emergency department response to women experiencing intimate partner violence: Insights from interviews with clinicians in Australia.

Publication Type:
Journal Article
Citation:
Acad Emerg Med, 2019
Issue Date:
2019-02-28
Metrics:
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BACKGROUND AND OBJECTIVES: Emergency departments are essential providers of compassionate, immediate treatment and referral for women experiencing intimate partner violence. Intimate partner violence, largely perpetrated by men against women, exerts a substantial burden on the health systems and economies of all nations. There is little known about how staff in Australian emergency departments respond to the challenges such violence generates. We therefore examined the clinical team response to women experiencing intimate partner violence in two large Australian metropolitan hospital emergency departments. METHODS: We undertook qualitative semi-structured interviews and focus group discussions with 35 social workers, nurses and doctors. Transcripts were recorded and transcribed verbatim. We analyzed the data thematically. We first undertook line by line coding and organized content into descriptive categories. Latent and manifest patterns were identified across the data and mapped to key themes in negotiation with all authors. RESULTS: Respondents emphasized challenges identifying intimate partner violence resulting from professional uncertainty or discomfort and women's fear of the ramifications of disclosure. Emergency clinicians routinely referred women to social workers after medical treatment and described effective collaboration across professions. Social workers outlined difficulties coordinating care with health and community agencies. Staff highlighted challenges maintaining non-judgmental attitudes and managing their own feelings - especially clinicians who had personally experienced violence. CONCLUSIONS: EDs can provide caring environments for women experiencing intimate partner violence. Effective interprofessional teamwork across nursing, medical and social work professionals may mitigate the need for formal screening tools. Supportive workforce environments can improve staff understanding, reduce stigma, enhance appropriate treatment and counsel health professionals experiencing violence. However, staff training and advocacy, and referral relationships with local programs require strengthening. A connected multi-systems-level response is required to co-ordinate and resource services for all affected by violence. This article is protected by copyright. All rights reserved.
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