HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Supplemental data: Appendix In Brief TRACK Comments: Submit a response TRACK Comments: View responses Alert me when this article is cited Alert me when TRACK Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zink, T. Articles by Klostermann, B. Search for Related Content PubMed PubMed Citation Articles by Zink, T. Articles by Klostermann, B.

Medical Management of Intimate Partner Violence Considering the Stages of Change: Precontemplation and Contemplation

¹ Department of Research, Olmstead Medical Center, Rochester, Minn
² Department of Family Medicine, University of Cincinnati, Cincinnati, Ohio
³ Institute of Health Policy and Health Services Research, University of Cincinnati, Cincinnati, Ohio

CORRESPONDING AUTHOR: Therese Zink, MD, MPH, Department of Research, Olmsted Medical Center, 210 9th St SE, Rochester, MN 55904, tzink{at}olmmed.org

BACKGROUND We undertook a study to understand how women who are victims of intimate partner violence (IPV) want physicians to manage these abusive relationships in the primary care office.

METHODS Thirty-two mothers in IPV shelters or support groups in southwestern Ohio were interviewed to explore their abuse experiences and health care encounters retrospectively. The interviews were taped and transcribed. Using thematic analysis techniques, transcripts were read for indications of the stages of change and for participants’ desires concerning appropriate physician management.

RESULTS Participants believed that physicians should screen women for IPV both on a routine basis and when symptoms indicating possible abuse are present, even if the victim does not disclose the abuse. Screening is an important tool to capture those women early in the process of victimization. When a victim does not recognize her relationship as abusive, participants recommended that physicians raise the issue by asking, but they also warned that doing more may alienate the victim. Participants also encouraged physicians to explore clues that victims might give about the abuse. In later contemplation, victims are willing to disclose the abuse and are exploring options. Physicians were encouraged to affirm the abuse, know local resources for IPV victims, make appropriate referrals, educate victims about how the abuse affects their health, and document the abuse. Participants identified a variety of internal and external factors that had affected their processes.

CONCLUSIONS In hindsight, IPV victims recommended desired actions from physicians that could help them during early stages of coming to terms with their abusive relationships. Stage-matched interventions may help physicians manage IPV more effectively and avoid overloading the victim with information for which she is not ready.

Key Words: Domestic violence • process of change • transtheoretical model

This article has been cited by other articles:

				T. Zink, L. Levin, F. Putnam, and A. Beckstrom Accuracy of Five Domestic Violence Screening Questions With Nongraphic Language Clinical Pediatrics, March 1, 2007; 46(2): 127 - 134. [Abstract] [PDF]

				A. Raj, K. N. Livramento, M. C. Santana, J. Gupta, and J. G. Silverman Victims of intimate partner violence more likely to report abuse from in-laws. Violence Against Women, October 1, 2006; 12(10): 936 - 949. [Abstract] [PDF]

				T. Zink, L. Levin, P. Wollan, and F. Putnam Mothers' Comfort with Screening Questions about Sensitive Issues, Including Domestic Violence. J Am Board Fam Med, July 1, 2006; 19(4): 358 - 367. [Abstract] [Full Text] [PDF]

				G. S. Feder, M. Hutson, J. Ramsay, and A. R. Taket Women Exposed to Intimate Partner Violence: Expectations and Experiences When They Encounter Health Care Professionals: A Meta-analysis of Qualitative Studies Arch Intern Med, January 9, 2006; 166(1): 22 - 37. [Abstract] [Full Text] [PDF]

				T. Zink and F. Putnam Intimate Partner Violence Research in the Health Care Setting: What Are Appropriate and Feasible Methodological Standards? J Interpers Violence, April 1, 2005; 20(4): 365 - 372. [Abstract] [PDF]

				L. M. Meadows, L. Mrkonjic, and L. Lagendyk Women's Perceptions of Future Risk After Low-Energy Fractures at Midlife Ann. Fam. Med, January 1, 2005; 3(1): 64 - 69. [Abstract] [Full Text] [PDF]

				K. C. Stange Improving Health Care Locally and Globally Ann. Fam. Med, July 1, 2004; 2(4): 368 - 370. [Full Text] [PDF]

				K. C. Stange and W. L. Miller In This Issue: The Patient Voice, Clinical Research, Clustered Data, and the Wonca Research Conference Ann. Fam. Med, May 1, 2004; 2(3): 194 - 197. [Full Text] [PDF]

TRACK Comments: