First Contact: Acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence

My paper ‘First Contact: Acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence’ was recently published. This paper and the research findings it reports arose from my practice as an emergency nurse providing care for women in the immediate aftermath of being physically assaulted by their partner. During these encounters many women were distressed and troubled and I sometimes felt that I might not be best meeting women victim-survivors’ needs for the short and longer term. These practice experiences made me think about women’s experiences of going to an emergency department after being assaulted by their partner, question our practices in responding, and consider what good consultation outcomes for women victim-survivors might look like.

This paper is the first to be published from my research, part of which involved interviewing women victim-survivors of intimate partner violence about their experiences of attending an emergency department after being physically assaulted by their partner. For this work it was important for women victim-survivor participants’ voices to be forefront and central. I hope I have managed to do this. Looking back on my practice as an emergency nurse I do not think that I had the range and depth of knowledge and skills to deliver best possible consultation outcomes. I hope that the findings from this research will be helpful to practitioners responding to and caring for victim-survivors of partner violence and improve victim-survivor health consultation outcomes and experiences in the future.

With thanks to the women who gave up their time to participate in this research without whom this paper and their knowledge would not available to us all.

 

Paper details: Olive, P. (2016) ‘First Contact: Acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence’, Journal of Clinical Nursing DOI:10.1111/jocn.13311.

ABSTRACT

Aims and objectives:
The aim of this research was to explore women’s emotional and affective responses following an incident of intimate partner violence experienced during emergency department attendances.

Background:
A growing body of research has explored women’s experiences of emergency departments following intimate partner violence still little remains known about the experience and impact of emotional and affective responses during these attendances.

Design:
A descriptive qualitative design was used, underpinned theoretically by critical realism and postmodern complexity theory to attend to multiple, intersecting mechanisms that lie behind events and experiences.

Methods:
Semi-structured interviews with six women who had attended an emergency department directly following an incident of intimate partner violence. Interview data were transcribed and thematically analysed in NVIVO9 using a coding framework.

Results:
There were three interconnected key findings. First, was the commonality of acute stress experiences among women attending an emergency department following partner violence, second was that these acute stress reactions negatively impacted women’s consultations, and third was the need for specialist domestic violence services at the point of first contact to assist service users navigate an effective consultation.

Conclusions:
Acute stress reactions were an important feature of women’s experiences of emergency department consultations following intimate partner violence. Attending to psychological first aid; providing a safe and quiet space; and affording access to specialist violence advocacy services at the point of first contact will limit harm and improve health consultation outcomes for this population.

Relevance to clinical practice:
This research provides an account of emotional and affective responses experienced by women attending emergency departments following intimate partner violence and explicates how these acute stress reactions impacted their consultation. This research has relevance for practitioners in many first contact health services, such as urgent and emergency care, general practice, community public health and mental health.

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Why does intimate partner violence get missed in emergency departments in England?

Thesis

This question: ‘Why does intimate partner violence get missed in emergency departments in England?’, was the starting point for my PhD research. The resultant research and thesis, ‘Classifications of intimate partner violence in hospital-based, emergency department health systems’ focused on how intimate partner violence was classified (and responded to) in emergency department consultations and in national (HES) and international (ICD-10) administrative health information systems. I was interested in the planes (and anomalies) of classifications of violence mobilised, and the significance (at different levels of health systems) that classifying partner violence in particular ways made to health care trajectories and health data.

I am currently writing and publishing articles from this study and welcome any opportunity to share, so if interested and would like more detail or information, please get in touch either through ResearchGate (Philippa Olive) or Twitter (@philippaolive).

‘Finding Cases’ – the challenges of undertaking systems level research about intimate partner violence in hospital-based health systems in England

Finding Cases Poster

‘Finding Cases’ was about the challenges for undertaking systems level research about intimate partner violence in hospital-based health systems in England. I developed this poster for an NIHR annual trainees’ conference and for the Lancaster University, Faculty of Health and Medicine advent research colloquium.

site tag cloud

sociology of violence, physical violence, sexual violence, psychological violence, emotional violence, economic violence, coercion, stalking, harassment, cyber-violence, structural violence, cultural violence, symbolic violence, intersectionality, inequality, intersectional violence, gender inequality, gender-based violence, sociology of health,  social determinants of health, health inequalities,  health impacts, measures of health, global burden of disease, GBD, valuing health, sociology of science, social science, critical realism, complexity theory, post-modernism, sociology of diagnosis, health systems, health information systems, international classification of diseases, ICD-10, injury surveillance systems,