Title: “The questions made me realize how many times I could have been saved and removed
from that situation”: The Experiences of Patients Attended to by Paramedics for Intimate Partner
Violence, and Actionable Implementations for Paramedicine
Version: 1 Date: 01 Apr 2025
Reviewer's report:
The purpose of the research was to examine the experiences of IPV survivors seeking services
from paramedics to inform and improve clinical practice. The study presents a qualitative
analysis using an interpretive description approach to synthesize data from 9 female IPV
survivors who interacted with paramedicine services in three provinces of Canada. The
results examine challenges experienced by survivors as well as survivor-derived or co-derived
solutions. The authors did a nice job presenting the findings in a compelling narrative, and the
paper is well-written.
General
Though the journal does not have a word limit, the manuscript is quite long. The authors might
consider reducing some of the content in the methods section and reviewing the entire manuscript
to limit wordiness throughout.
Methods
What was the timeframe in which participants had to have used the paramedic services for IPV-
related injury to be eligible for the study? If there was no such eligibility criteria, it may still
be useful to mention the timeframe that they last used the services in the results section if the
information is available.
The methods mention that participant recruitment ended after exerting a certain amount of effort
and resources, but what was the sample size goal and justification? The authors later mention
that the study was limited by a small sample size, but the reader has no context for this, i.e. what
sample size the authors were hoping for and why? As the results appear very rich, what in the
data indicated that the sample was too small? Or was it the make up of the sample – not having
enough survivors with very positive paramedic experiences – rather than the size?
Was participant consent obtained to audio record the interviews? If so, please state.
Results
Please qualify which of the forms of sexual IPV were most or least commonly experienced in the
sample. “Participants reported that sexual IPV was a regular occurrence. Sexual IPV experiences
included rape, forced penetration with various objects, forced sex work, date rape, and human
trafficking.” Pg16
The authors might consider moving results tables 2 and 3 to a supplementary file rather than
embedded within the manuscript. The content in the tables, though interesting, seems to be
already presented in summative form in the text, and the table format adds unnecessary length
to the main text.
In the Survivor’s Challenges to Receiving Paramedic Services section, it may benefit the reader
to name the seven most impactful challenges in the text at the beginning of the section as well
as introduce a third level of headings to label the paragraphs that discuss each challenge.
If moving table 3 to supplemental material, the Survivor Challenges section should then include
quotations throughout the section to break up the text and add contextualization.
Discussion
Is the second sentence on page 31 (below) supposed to explain the findings of Leppakoski (46)?
If so, more information is required for it to be useful.
“Leppäkoski (46) did continue their line of work by engaging with in-emergency department
healthcare providers through a questionnaire and, in a subset, follow-up interviews. A disconnect
between in-community services and in-hospital healthcare services may exist.”
Please clarify this sentence on page 32 or provide an example of what such an innovation would
look like. “Paramedics and paramedic services should build considerations for IPV-caused brain
injury into innovations at the intersection of paramedicine and IPV.”
Please provide a citation for this sentence on page 33. “Novel pathways for different clinical
circumstances are being developed and deployed to better meet the needs of patients.”
References
Citation number 1 and 48 appear to be the same. Please review bibliography for typos.