Intimate partner violence: patients' experiences and perceptions in family practice

OBJECTIVE: To understand how women affected by intimate partner violence (IPV), felt their family physicians cared for them and to identify where gaps in care exist. METHODS: Interviews were conducted with ten women (mean age 50 years and minimum to maximum ages of 40-73 years). Content analysis was used to identify common themes. RESULTS: Women acknowledged a lack of insight into their abusive relationships given a lack of physical violence, preconceptions about IPV or presumed reasons their abusers had for violence. After identifying abuse, most shared feelings of fear, preventing them from disclosure. They feared being judged, not believed and consequences from their abuser. Perceptions' about their family physician's role prevented disclosure particularly misconceptions regarding physician's interest and time to discuss non-medical issues. After disclosure, women valued their family physicians listening, following up, providing validation and advocacy. All women experienced isolation secondary to the abuser, the family practice clinic, the physician and/or the 'system' itself. CONCLUSIONS: Women were not aware of family doctors' interest in issues aside from physical health. They appreciated a confidential and non-threatening environment and valued follow-up and advocacy on their behalf. They expressed frustration with open access scheduling and multiple providers. To improve care, family physicians should educate patients about their role, provide safe environments for disclosure and offer follow-up and support. Recommended system changes include measures to ensure continuity of care and easy booking of appointments. Finally, family physicians should recognize that there is a need to follow these patients long term as the effects of IPV are long lasting.