Reviewer's report
Title:Midlife women's stages of change from violence towards freedom
Version:1Date:15 April 2015
Reviewer: Tina L. Bloom
Reviewer's report:
Article Title: Midlife women’s stages of change from violence towards freedom
Overall summary: This paper represents findings of a qualitative analysis of
interviews with women age 40-55 who had accessed residential and
non-residential DV services and self-defined as DV survivors (N = 15). The
purpose of the study was to describe midlife women’s experiences with domestic
violence – it appears the focus was specifically with leaving.
There’s a lot to like here.
• Lit review concise, synthesizes a good-size body of literature fairly well and
makes a convincing case that the manuscript addresses a gap in the literature
and adds to existing knowledge.
• I found the content interesting and I think it could be a nice addition to the
literature.
• The content appears relevant to the readership of BMC Women’s Health and
fits the scope of the journal.
However, there are some weaknesses in the structure of the paper that should
be addressed. I think all will improve the paper and hope the authors find them
useful. Thank you for the opportunity to review this interesting work. I wish the
authors the best of luck in their future endeavors and hope they continue to
address the needs of underrepresented survivors.
Major Compulsory Revisions:
1. Methods section: needs eligibility criteria (inclusion/exclusion criteria); how the
sample size was determined? Considerations of data saturation should be
addressed – particularly as this study has a very small sample size; description
of measures (descriptive/demographic data collected, interview guide and how
developed/what it addressed); were participants compensated?
2. Findings: Final sample size, demographics and descriptive data should be
presented here, not in the methods section, and more clearly and thoroughly in
either the text or in a table – age, race/ethnicity, length of relationship, children,
employment, etc. so this information can be found more readily – it is important
to the context and thinking how these results apply to other samples.
3. Discussion: I think the authors’ findings are interesting but can be further
contextualized:
a. In the literature review, the authors note leaving is described as a cyclical
process with typically multiple attempts to leave before the final end. The authors
describe the decision-making of the women in their sample as appearing to be a
“one-off” decision rather than a process. However, what I’m not seeing discussed
is that the women in this sample had been in their abusive relationship for quite
some time – 13-27 years? Therefore -- is it possible they had left more than
once? Or was this part of the eligibility criteria – that they had left for the first
time? If so, why do the authors think these women were different than other
women? Does this have safety planning or service provider implications? I think
they have addressed this obliquely but I think this is a significant finding and
should be elaborated on a bit more.
b. Like most DV research, this study utilizes a sample of women who have
accessed DV services. The vast majority of women who experience DV (80% or
upward; see Ansara & Hindin, 2010; Fanslow & Robinson, 2010; Fugate, Landis,
Riordan, Naureckas, & Engel, 2005; Goodman, Dutton, Vankos, & Weinfurt,
2005; Meyer, 2010) never access these services. So -- there are likely important
differences between samples of women recruited from such services compared
to the general population of women experiencing IPV. This doesn’t mean the
findings of this study aren’t useful, but I think this should be noted in the
discussion; it could be described as a limitation, or simply as an implication for
future research.
c. Similarly, because of this issue above, it would be helpful to more clearly
describe the samples from previous literature (in the literature review) both in
terms of actual age ranges represented and where the samples were drawn from
(i.e., community-based versus shelter/women accessing formal violence
services).
Minor Essential Revisions:
4. Title: Nicely done, but needs to include a description of the study design
5. Abstract: could use minor revisions for clarity. Specifically, it would be
improved by clearly stating the purpose of the study, including the sample size,
and including a clearer statement that the study is qualitative in nature and
naming the analysis approach. I would also recommend having another look at
line 16, which states that participants were informed that the study was “entirely
independent of the agencies and that no information was shared with them” – as
I assume what the authors mean here is not that they did not share the study
findings/what they learned with their community partners, but rather that no
information that could have identified survivors was shared with the agencies.
6. Lit review: needs a clearer, tighter purpose statement for this study – it is an
entire paragraph and doesn’t seem to fit the manuscript. At first it appears the
purpose is to describe midlife women’s experiences with DV (broadly), but the
rest of the manuscript suggests the purpose here was more focused primarily to
describe their process of leaving (specifically) – in either case, it could use
clarification.
7. Some language/sentence structure is awkward and there are numerous
typographical/other errors -- the article could use a copy-editor. Some bits that
stuck out included these (this is not an exhaustive list):
a. line 38-39: “30% of women experiencing physical and/or sexual violence and
38% being murdered by their intimate partner”—the second part of this needs
clarification, as it would seem to suggest an overall prevalence of 38% of the
global population of women die from intimate partner homicide;
b. Line 59: “potentially leading to a change in the woman’s identity” – not sure
what is meant by identity here? (how the woman perceives herself, or does this
mean she is going into hiding?)
c. Line 89-90 – reference to “physical scales” or “psychometric scales” is
confusing – do the authors mean that the outcome measures usually address
exposures to violence or associated physical and mental health outcomes?
d. Line 272-274 isn’t a complete sentence
e. line 18 “semi structure interviews” instead of “semi-structured;”
f. line 29 says “stages so change” instead of “stages of change”
g. line 163 should say “principal investigators” not “Principle”;
h. Citation and reference list need to be reformatted to journal specifications;
i. Address inconsistent capitalization of article titles in bibliography
j. Home Office (2011) is not cited in-text that I can find
Discretionary Revisions:
8. I would suggest moving the section where the authors describe the varying
definitions of midlife/older women found in the literature to an earlier place in the
manuscript – it feels a little overly long and out of place. Things might flow more
nicely if they could condense ~lines 68-74 and perhaps work it into the 2nd
paragraph where they begin to describe the gap in the literature – and work line
75-76 (how they defined midlife for their own study) into the methods section.
9. I’m not a huge fan of combining findings with discussion, as I think the
discussion ends up getting somewhat short shrift, but I see this is permitted by
this journal.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests.