Jo Spangaro1, Jane Koziol-McLain2, Anthony Zwi3, Alison Rutherford4, Mary-Anne Frail5, Jennifer Ruane6. 1. School of Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: j.spangaro@unsw.edu.au. 2. Centre for Interdisciplinary Trauma Research, Auckland University of Technology, Private Bag 92006 Auckland, 1142, New Zealand. Electronic address: jane.koziol-mclain@aut.ac.nz. 3. School of Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: a.zwi@unsw.edu. 4. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: a.rutherford@unsw.edu.au. 5. School of Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: m.frail@unsw.edu.au. 6. School of Social Sciences, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: j.ruane@unsw.edu.au.
Abstract
RATIONALE: Intimate partner violence (IPV) is a significant global public health risk causing premature death and morbidity that largely remains hidden. Understanding decisions about whether or not to disclose abuse when asked about it in health settings is important to ensuring that those experiencing violence are provided with access to services to support their safety and wellbeing. OBJECTIVE: This study tested a model for women's decisions to disclose IPV in response to routine inquiry as part of antenatal assessment. METHODS: Qualitative configurational analysis, suited to the study of causal pathways in complex social phenomena, was used to analyse interviews with 32 women who had experienced IPV in the past 12 months and who elected, when asked, to either disclose this to the midwife (n = 24) or not to do so (n = 8). FINDINGS: Multiple pathways to disclosure were identified. While no single factor was necessary or sufficient for a decision to disclose, direct asking and care, defined as showing interest and a non-judgemental attitude, were found to be key conditions. The absence of care was also central to decisions not to disclose, as were perceptions of relevance of the abuse at the time of assessment. CONCLUSION: Confirming key elements of the original model, these findings highlight the importance of being asked about abuse in women's decisions to disclose, as well as the relational nature of this process. Trauma-informed practices for identifying and responding to intimate partner violence are needed.
RATIONALE: Intimate partner violence (IPV) is a significant global public health risk causing premature death and morbidity that largely remains hidden. Understanding decisions about whether or not to disclose abuse when asked about it in health settings is important to ensuring that those experiencing violence are provided with access to services to support their safety and wellbeing. OBJECTIVE: This study tested a model for women's decisions to disclose IPV in response to routine inquiry as part of antenatal assessment. METHODS: Qualitative configurational analysis, suited to the study of causal pathways in complex social phenomena, was used to analyse interviews with 32 women who had experienced IPV in the past 12 months and who elected, when asked, to either disclose this to the midwife (n = 24) or not to do so (n = 8). FINDINGS: Multiple pathways to disclosure were identified. While no single factor was necessary or sufficient for a decision to disclose, direct asking and care, defined as showing interest and a non-judgemental attitude, were found to be key conditions. The absence of care was also central to decisions not to disclose, as were perceptions of relevance of the abuse at the time of assessment. CONCLUSION: Confirming key elements of the original model, these findings highlight the importance of being asked about abuse in women's decisions to disclose, as well as the relational nature of this process. Trauma-informed practices for identifying and responding to intimate partner violence are needed.
Authors: Donna E Stewart; Simone N Vigod; Harriet L MacMillan; Prabha S Chandra; Alice Han; Marta B Rondon; Jennifer C D MacGregor; Ekaterina Riazantseva Journal: Curr Psychiatry Rep Date: 2017-05 Impact factor: 5.285
Authors: Jessica R Williams; Brian E McCabe; Lila de Tantillo; Kristin Levoy; Victoria Behar-Zusman Journal: Issues Ment Health Nurs Date: 2020-09-23 Impact factor: 1.835
Authors: Jane Koziol-McLain; Christine McLean; Maheswaran Rohan; Rose Sisk; Terry Dobbs; Shyamala Nada-Raja; Denise Wilson; Alain C Vandal Journal: J Med Internet Res Date: 2016-10-25 Impact factor: 5.428
Authors: Caroline A Fisher; Nadine Rudkin; Toni D Withiel; Amanda May; Elizabeth Barson; Beverley Allen; Emma O'Brien; Karen Willis Journal: Womens Health (Lond) Date: 2020 Jan-Dec