Women's perspectives on intimate partner violence services: the hope in Pandora's box.

Ruth Petersen, Kathryn E Moracco, Karen M Goldstein, Kathryn Andersen Clark
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Abstract

Objective: To explore women's perspectives about how to enhance services for those who experience intimate partner violence (IPV) and how to improve the links between such services and the health care setting.

Methods: We conducted 6 focus groups involving 67 women in both rural and urban settings in North Carolina. A standardized interview guide was used to investigate the women's perspectives on the study objectives. Coding and theme analyses were conducted to assess new ideas and/or common themes among the groups.

Results: Participants identified currently available services for women experiencing IPV, including health care providers, police and the legal system, domestic violence shelters, and churches. Participants discussed existing barriers to addressing violence within the health care system, including cost of medical services, risk of having social services remove their children, violence being too personal to discuss, and doctors' inability to provide what they thought victims really needed. Participants agreed that the most important role for providers would be referrals to useful services (advocacy, job training, and financial support). Participants also emphasized the need for community-based prevention efforts.

Conclusion: We found a striking lack of support among women participants in our study for using the health care setting as part of the service response to IPV. Participants believed that the health care system is not set up to allow providers to provide the level of individual assistance that they thought would be most useful. Participants did have hope that women's risk of future IPV would decrease if they were provided with useful community-based services and if community-wide prevention efforts were implemented.

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妇女对亲密伴侣暴力服务的看法:潘多拉盒子里的希望。
目的:探讨妇女对如何加强对遭受亲密伴侣暴力的人的服务以及如何改善这种服务与保健环境之间的联系的看法。方法:我们进行了6个焦点小组,涉及67名妇女在农村和城市设置在北卡罗莱纳州。采用标准化访谈指南调查女性对研究目标的看法。进行编码和主题分析,以评估小组之间的新想法和/或共同主题。结果:与会者确定了目前为遭受IPV的妇女提供的服务,包括卫生保健提供者、警察和法律系统、家庭暴力庇护所和教堂。与会者讨论了在卫生保健系统内解决暴力问题的现有障碍,包括医疗服务费用、社会服务机构带走孩子的风险、暴力过于个人化而无法讨论,以及医生无法提供他们认为受害者真正需要的东西。与会者一致认为,提供者最重要的作用是介绍有用的服务(宣传、职业培训和财政支助)。与会者还强调需要开展以社区为基础的预防工作。结论:我们发现,在我们的研究中,女性参与者明显缺乏对使用卫生保健机构作为IPV服务响应的一部分的支持。与会者认为,现时的医疗制度,并不是容许提供者提供他们认为最有用的个别援助。与会者确实希望,如果向妇女提供有用的社区服务并在社区范围内开展预防工作,她们今后患IPV的风险将会降低。
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