Women Exposed to Acute Physical Intimate Partner Violence Seeking Care at Emergency Departments - Identification of and Intervention in Violence

The purpose of this descriptive, cross-sectional multi-center study is to create a preliminary model for identifying women exposed to acute physical intimate partner violence seeking care at emergency departments and for intervening in the violence. The model is based on the results of previous research and the present study. Research material was collected during 2000-2004 with questionnaires given to women exposed to acute physical intimate partner violence (n = 35) and emergency department professionals (n = 480). Moreover, semi-structured interviews were carried out with seven women and 20 emergency department professionals. The data were analysed using quantitative and qualitative methods. Twenty-eight emergency departments from all over Finland participated in the study. The results of the present study revealed that among the women seeking care for their acute physical injuries the lifetime prevalence of physical intimate partner violence was 94%. Eighty-six per cent of the women had previously experienced physical violence by their current partner and 97% of past and 56% of acute cases of physical violence were accompanied by psychological violence. Physical violence had resulted in contusions, wounds and fractures. Some of the women’s children had witnessed (seen and/or heard) violence between their parents and some had also been exposed to physical violence. The women studied described their positive and negative experiences of care as patients at an emergency department in many ways. The important factors in a good relationship between a patient and a health care professional included appropriate medical care of injuries with elements of emotional (desire to be listened to and understood) and practical support (providing information on different help services). The women regarded care principles such as kind and confidential care relationship and secure care environment as important. The women expressed their concern about their children and partners and also wanted them to be helped. The results of the present study revealed that those emergency department professionals who had common practices and written procedures for handling intimate partner violence reported having helped both women and perpetrators more often than the professionals without procedures. Good co-operation with different help providers and possibilities to consult them facilitated intervention methods. Those professionals who had received more training on intimate partner violence reported better skills in identifying intimate partner violence and intervening in it. The research results suggest that improvement of practical nursing care requires that training be arranged and co-operation with different help providers be developed, and a jointly agreed model be introduced to address intimate partner violence. This is everyone’s professional, ethical duty and also based on legislation. However, an implementation of the model demands the support of those in positions of nursing administration. The functionality of the model developed is the next step for further research and will be tested in practice.