Health needs and barriers to healthcare of women who have experienced intimate partner violence.

BACKGROUND: This study assessed the health needs and barriers to healthcare among women with a history of intimate partner violence (IPV) as told by women themselves.
METHODS: Qualitative interviews were conducted with 25 women clients and 10 staff members at a crisis center in metropolitan North Carolina. Clients also completed a structured survey.
RESULTS: Eleven shelter clients and 14 walk-ins completed the survey and interview. Client participants were demographically mixed, and 20% were Spanish-speaking immigrants. Most clients were unemployed and uninsured. Women reported worse health in the interviews than on the surveys; clients' major health needs were chronic pain, chronic diseases, and mental illness. Reported barriers to healthcare were cost, psychological control by the abuser, and low self-esteem and self-efficacy. Staff's perceptions of clients health needs differed from clients,' focusing on reproductive health, HIV/sexually transmitted infection (STI), mental illness, and inadequate preventive healthcare. Staff and clients' perceptions of barriers to healthcare were more congruent. Suggestions for improving the center's response were to offer more health education groups and more health-related staff trainings. Agency barriers to implementing these changes were limited funding, focus on crisis management, and perceived disconnect with the healthcare system.
CONCLUSIONS: Health needs of women who have experienced IPV are significant and include physical and mental concerns. IPV creates unique barriers to accessing healthcare, which can be addressed only partially by a crisis center. Greater coordination with the healthcare system is needed to respond more appropriately to the health needs of women who have experienced IPV.