2004
Volume 24, Issue 2
  • ISSN: 1388-3186
  • E-ISSN: 2352-2437

Abstract

Abstract

Intimate Partner Violence (IPV) is a major societal problem with significant healthcare implications. The consequences of this kind of violence result in victims (and perpetrators) regularly needing healthcare. Various structural barriers can prevent victims from accessing services or result in inadequate responses to their needs. International research shows that general practitioners can play an important role in tackling IPV but that they also are confronted with various difficulties themselves. Drawing on seventeen in-depth interviews with general practitioners in Flanders, we discuss in this article the experiences of GPs who come across IPV in their health care practice. We use an intersectional approach to better understand the difficulties GPs face by looking at the complexity underlying these cases and by exploring GPs’ understanding of vulnerabilities of marginalised groups. A thematic data analysis was applied. Using a number of case studies, we found that GPs are confronted with various structural barriers that complicate the care of patients who are victims of IPV. This gives rise to alternative care strategies, which are based on a sentiment of ‘involved incertitude’.

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2021-12-03
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References

  1. Annandale, E., Harvey, J., Cavers, D., & Dixon-Woods, M.(2007). Gender and access to healthcare in the UK: A critical interpretive synthesis of the literature. Evidence & Policy: A Journal of Research, Debate and Practice, 3(4), 463–486.
    [Google Scholar]
  2. Bacchus, L., Bewley, S., Fernandez, C., Hellbernd, H., Lo Fo Wong, S., Otasevic, S., . . .Savola, T.(2012). Health sector responses to domestic violence in Europe: A comparison of promising intervention models in maternity and primary care settings. Beschikbaar: diverhse.eu
  3. Barton, K.C.(2015). Elicitation techniques: Getting people to talk about ideas they don’t usually talk about. Theory & Research in Social Education, 43(2), 179–205.
    [Google Scholar]
  4. Bauer, G.R.(2014). Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity. Social science & medicine, 110, 10–17.
    [Google Scholar]
  5. Bent-Goodley, T.B.(2007). Health disparities and violence against women: Why and how cultural and societal influences matter. Trauma, Violence, & Abuse, 8(2), 90–104. doi:10.1177/1524838007301160
    [Google Scholar]
  6. Bograd, M.(1982). Battered women, cultural myths, and clinical interventions: A feminist analysis. Women & Therapy, 1(3), 69–78.
    [Google Scholar]
  7. Bonomi, A.E., Anderson, M.L., Rivara, F.P., & Thompson, R.S.(2009). Health care utilization and costs associated with physical and nonphysical-only intimate partner violence. Health Services Research, 44(3), 1052–1067. doi:10.1111/j.1475‑6773.2009.00955.x
    [Google Scholar]
  8. Bossuyt, N., & van Casteren, V.(2009). Domestic violence: Variation in case-management by the general practitioner in Belgium. International journal of public health, 54(2), 106–111.
    [Google Scholar]
  9. Burman, E., & Chantler, K.(2005). Domestic violence and minoritisation: Legal and policy barriers facing minoritized women leaving violent relationships. International journal of law and psychiatry, 28(1), 59–74.
    [Google Scholar]
  10. Campbell, J. C.(2002). Health consequences of intimate partner violence. Lancet, 359(9314), 1331–1336.
    [Google Scholar]
  11. Cès, S., & Baeten, R.(2020). Inequalities in access to healthcare in Belgium. Beschikbaar: ose.be/files/publication/health/2020_Ces_Baeten_NIHDI_Inequalities_access_care_Report_EN.pdf
  12. Collins, P.H., & Bilge, S.(2016). Intersectionality. Cambridge: John Wiley & Sons.
  13. Crenshaw, K.(1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299. doi:10.2307/1229039
    [Google Scholar]
  14. De Deken, L., Pas, L., Hillemans, K., & Cornelis, E.(2010). De huisarts in contact met partnergeweld. Een evidence-based onderbouwd werkmodel. Huisarts Nu, 39, 339–345.
    [Google Scholar]
  15. Drieskens, S., & Demarest, S.(2015). Onderzoek naar intrafamiliaal geweld en partnergeweld op basis van de gezondheidsenquête 2013. Beschikbaarhttps://igvm-iefh.belgium.be/sites/default/files/rapport_intrafamiliaalgeweld_final_nl.pdf
  16. Frank, A.W.(2014). Narrative ethics as dialogical story‐telling. Hastings Center Report, 44(s1), S16–S20.
    [Google Scholar]
  17. Garcia-Moreno, C., Hegarty, K., d’Oliveira, A.F.L., Koziol-McLain, J., Colombini, M., & Feder, G.(2015). The health-systems response to violence against women. Lancet, 385(9977), 1567–1579. doi:10.1016/s0140‑6736(14)61837‑7
    [Google Scholar]
  18. Gear, C., Eppel, E., & Koziol-Mclain, J.(2018). Utilizing complexity theory to explore sustainable responses to intimate partner violence in health care. Public Management Review, 20(7), 1052–1067. doi:10.1080/14719037.2017.1364407
    [Google Scholar]
  19. Grant, J., Mottet, L., Tanis, J., Herman, J.L., Harrison, J., & Keisling, M.(2010). National transgender discrimination survey report on health and health care. Beschikbaartransexualia.org/wp-content/uploads/2015/03/Sanidad_ntdsreportonhealth.pdf
  20. Green, M.A., Evans, C.R., & Subramanian, S.V.(2017). Can intersectionality theory enrich population health research?Social science & medicine, 178, 214–216.
    [Google Scholar]
  21. Hancock, A.-M.(2007). Intersectionality as a normative and empirical paradigm. Politics & Gender, 3(2), 248–254.
    [Google Scholar]
  22. Hankivsky, O.(2012). Women’s health, men’s health, and gender and health: Implications of intersectionality. Social science & medicine, 74(11), 1712–1720.
    [Google Scholar]
  23. Hankivsky, O., Doyal, L., Einstein, G., Kelly, U., Shim, J., Weber, L., & Repta, R.(2017). The odd couple: Using biomedical and intersectional approaches to address health inequities. Global Health Action, 10(sup2), 1326686.
    [Google Scholar]
  24. Hegarty, K., Taft, A., James-Hanman, D., Johnson, M., & Feder, G.(2015). Interventions for intimate partner violence. Lancet, 385(9963), 111–112. doi:10.1016/s0140‑6736(15)60013‑7
    [Google Scholar]
  25. Jiwani, Y.(2006). Discourses of denial: Mediations of race, gender, and violence. Vancouver: UBC Press.
  26. Johnson, J.C., & Weller, S.C.(2001). Elicitation techniques for interviewing. In J.F.Gubrium & J.A.Holstein (Eds.), Handbook of interview research: Context and method (pp. 491–514): SAGE Publications.
    [Google Scholar]
  27. Kohler, S., Hohne, A., Ehrhardt, M., Artus, J., Seifert, D., & Anders, S.(2013). General practitioners and managing domestic violence: Results of a qualitative study in Germany. J Forensic Leg Med, 20(6), 732–735. doi:10.1016/j.jflm.2013.04.008
    [Google Scholar]
  28. Krug, E.G., Mercy, J.A., Dahlberg, L.L., & Zwi, A.B.(2002). The world report on violence and health. Lancet, 360(9339), 1083–1088.
    [Google Scholar]
  29. Lacroix, S., & Offermans, A.(2004). Partnergeweld. Rol van de huisarts. FOD Volksgezondheid, Veiligheid van de Voedselketen en Leefmilieu. Beschikbaar: https://www.health.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/gids_partnergeweld_7864414_nl.pdf
  30. Leung, T.P., Bryant, C., Phillips, L., & Hegarty, K.(2017). GPs’ perceived readiness to identify and respond to intimate partner abuse: Development and preliminary validation of a multidimensional scale. Aust N Z J Public Health, 41(5), 512–517. doi:10.1111/1753‑6405.12683
    [Google Scholar]
  31. Lo Fo Wong, S.(2006). The doctor and the woman who’fell down the stairs’. Family doctor’s role in recognising and responding to intimate partner abuse. Nijmegen: Radboud University Nijmegen.
  32. McKie, L., Fennell, B., & Mildorf, J.(2002). Time to disclose, timing disclosure: GPs’ discourses on disclosing domestic abuse in primary care. Sociology of Health & Illness, 24(3), 327–346. doi:10.1111/1467‑9566.00297
    [Google Scholar]
  33. Mork, T., Andersen, P.T., & Taket, A.(2014). Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: A qualitative study. Bmc Womens Health, 14, 74. doi:10.1186/1472‑6874‑14‑74
    [Google Scholar]
  34. Mravcak, S.A.(2006). Primary care for lesbians and bisexual women. Am Fam Physician, 74(2), 279–286.
    [Google Scholar]
  35. Murillo, P., San Sebastian, M., Vives-Cases, C., & Goicolea, I.(2018). Factors associated with primary care professionals’ readiness to respond to intimate partner violence in Spain. Gaceta Sanitaria, 32(5), 433–438. doi:10.1016/j.gaceta.2017.03.003
    [Google Scholar]
  36. Potter, L., & Feder, G.(2018). Healthcare responses to comestic violence: Why and how. In S.Holt, C.Överlien, & J.Devaney (Eds.), Responding to domestic violence: Emerging challenges for policy, practice and research in Europe (pp. 292–324). London: Jessica Kingsley Publishers.
    [Google Scholar]
  37. Prosman, G.J., Wong, S., Bulte, E., & Lagro-Janssen, A.L.M.(2012). Healthcare utilization by abused women: A case control study. European Journal of General Practice, 18(2), 107–113. doi:10.3109/13814788.2012.675503
    [Google Scholar]
  38. Ramsay, J., Rutterford, C., Gregory, A., Dunne, D., Eldridge, S., Sharp, D., & Feder, G.(2012). Domestic violence: Knowledge, attitudes, and clinical practice of selected UK primary healthcare clinicians. Br J Gen Pract, 62(602), e647–e655.
    [Google Scholar]
  39. Robinson, L., & Spilsbury, K.(2008). Systematic review of the perceptions and experiences of accessing health services by adult victims of domestic violence. Health & social care in the community, 16(1), 16–30.
    [Google Scholar]
  40. Roelens, K., Verstraelen, H., Van Egmond, K., & Temmerman, M.(2008). Disclosure and health-seeking behaviour following intimate partner violence before and during pregnancy in Flanders, Belgium: A survey surveillance study. European Journal of Obstetrics Gynecology and Reproductive Biology, 137(1), 37–42. doi:10.1016/j.ejogrb.2007.04.013
    [Google Scholar]
  41. Römkens, R.(2016). Bestemd voor binnenlands gebruik. Sociologie, 12(3), 295–319.
    [Google Scholar]
  42. Ruiz-Perez, I., Pastor-Moreno, G., Escriba-Aguir, V., & Maroto-Navarro, G.(2017). Intimate partner violence in women with disabilities: Perception of healthcare and attitudes of health professionals. Disabil Rehabil, 40(9), 1059–1065. doi:10.1080/09638288.2017.1288273
    [Google Scholar]
  43. Sokoloff, N.J., & Dupont, I.(2005). Domestic violence at the intersections of race, class, and gender: Challenges and contributions to understanding violence against marginalized women in diverse communities. Violence Against Women, 11(1), 38–64. doi:10.1177/1077801204271476
    [Google Scholar]
  44. Stark, E.(2009). Coercive control: The entrapment of women in personal life. New York: Oxford University Press.
  45. Sugg, N.K.(1991). Opening Pandora’s box: Primary care physicians’ response to domestic violence. (Unpublished doctoral dissertation). University of Washington, Seattle.
  46. Tilley, L., & Creupelandt, H.(2018). Voorbij de grenzen. Aanpak van huiselijk geweld in de huisartsenpraktijk. Huisarts Nu, 1, 18–19.
    [Google Scholar]
  47. Van Roy, K., Vyncke, V., Piccardi, C., De Maesschalck, S., & Willems, S.(2018). Diversiteit in gezondheid en gezondheidszorggebruik: analyse van de data uit de Belgische gezondheidsenquête. Beschikbaar: https://biblio.ugent.be/publication/8566661/file/8566674.pdf
  48. Vanroelen, C., Smeets, T., & Louckx, F.(2004). Nieuwe kwetsbare groepen in de Belgische gezondheidszorg. Gent: Academia Press.
  49. Williston, C., & Lafreniere, K.(2013). ‘Holy cow, does that ever open up a can of worms’: Health care providers’ experiences of inquiring about intimate partner violence. Health care for women international, 34(9), 814–831.
    [Google Scholar]
  50. Withaeckx, S., & Coene, G.(2013). Van de liefde geslagen? Nieuwe vormen van intrafamiliaal geweld. In G.Coene & S.Withaeckx (Red.), Tweespraak Vrouwenstudies (Vol. 11, pp. 57–84). Brussel: VUBPRESS.
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): gezondheidszorg; huisarts; intersectionaliteit; partnergeweld
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