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Responding to Domestic Violence in General Practice: A Qualitative Study on Perceptions and Experiences

DOI: 10.1155/2012/960523

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The perceptions and experiences among general practitioners (GPs) and nurses in identifying female patients experiencing domestic violence and referring patients to specialist agencies need to be clarified. Eleven GPs and six nurses participating in a multidisciplinary domestic violence training and support programme in east London and Bristol were interviewed. All participants recognised that identification of women experiencing domestic violence and offering support were part of their clinical roles. Perceived differences between GPs and nurses, including time constraints, level of patient interaction, awareness of patients' social history, scope of clinical interview, and patient expectations were used to explain their levels of domestic violence inquiry. Barriers to inquiry included lack of time, experience, awareness of community resources, and availability of effective interventions postdisclosure. Longstanding relationships with patients were cited both as barrier and facilitator to domestic violence disclosure. Some nurses reported discomfort with direct inquiry due to the lack of clinical experience in responding to domestic violence despite satisfaction with training. Future domestic violence training programmes should take into account potential differences between GPs and nurses, in terms of their clinical roles and the unique barriers encountered, in order to improve self-efficacy and to facilitate collaborative and effective responses. 1. Introduction Domestic violence is a pattern of threatening behaviour, violence, or abuse including psychological, physical, sexual, financial, or emotional abuse between adults in the same family or who are or have been intimate partners [1]. It is a severe breach of human rights with profound consequences, particularly for women who, compared to men, experience more sexual violence, more severe physical violence, and more coercive control from their partners [2, 3]. Domestic violence threatens women’s physical health, mental health, and social functioning, and poses a serious public health problem [4, 5]. Its impact is widespread internationally, with lifetime prevalence ranging from 15% to 71% in a WHO multicountry study [6]. In the UK, 30% of women have experienced domestic abuse in their lifetime and 7% within the past year [7]. Its prevalence in women seeking healthcare is even higher; among women attending general practices in east London, 41% had experienced physical or sexual violence in their lifetime and 17% within the past year [8]. Primary care clinicians potentially have a key role in the

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