<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_sjph-2016-0002_s_343_w2aab3b8b2b1b7b1aab1c15b1Aa"><h3>Introduction</h3><p>In 1996 the World Health Organization declared intimate partner violence (IPV) the most important public health problem. Meta-analyses in 2013 showed every third female globally had been a victim of violence. Experts find screening controversial; family medicine is the preferred environment for identifying victims of violence, but barriers on both sides prevent patients from discussing it with doctors.</p></sec><sec id="j_sjph-2016-0002_s_344_w2aab3b8b2b1b7b1aab1c15b2Aa"><h3>Methods</h3><p>In July 2014, a qualitative study was performed through semi-structured interviews with ten family doctors of different ages and gender, working in rural or urban environments. Sound recordings of the interviews were transcribed, and the record verified. The data were interpreted using content analysis. A coding scheme was developed and later verified and analysed by two independent researchers. The text of the interviews was analysed according to the coding scheme.</p></sec><sec id="j_sjph-2016-0002_s_346_w2aab3b8b2b1b7b1aab1c15b3Aa"><h3>Results</h3><p>Two coding schemes were developed: one for screening, and the other for the active detection of IPV. The main themes emerging as barriers to screening were lack of time, staff turnover, inadequate finance, ignorance of a clear definition, poor commitment to screening, obligatory follow-up, risk of deterioration of the doctor-patient relationship, and insincerity on the part of the patient. Additionally, cultural aspects of violence, uncertainty/helplessness, fear, lack of competence and qualifications, autonomy/negative experience, and passive role/stigma/fear on the part of the patients were barriers to active detection.</p></sec><sec id="j_sjph-2016-0002_s_347_w2aab3b8b2b1b7b1aab1c15b4Aa"><h3>Conclusion</h3><p>All the participating doctors had had previous experience with active detection of IPV and were aware of its importance. Due to several barriers to screening for violence they preferred active detection.</p></sec></abstract>

IntroductionIn 1996 the World Health Organization declared intimate partner violence (IPV) the most important public health problem. Meta-analyses in 2013 showed every third female globally had been a victim of violence. Experts find screening controversial; family medicine is the preferred environment for identifying victims of violence, but barriers on both sides prevent patients from discussing it with doctors.MethodsIn July 2014, a qualitative study was performed through semi-structured interviews with ten family doctors of different ages and gender, working in rural or urban environments. Sound recordings of the interviews were transcribed, and the record verified. The data were interpreted using content analysis. A coding scheme was developed and later verified and analysed by two independent researchers. The text of the interviews was analysed according to the coding scheme.ResultsTwo coding schemes were developed: one for screening, and the other for the active detection of IPV. The main themes emerging as barriers to screening were lack of time, staff turnover, inadequate finance, ignorance of a clear definition, poor commitment to screening, obligatory follow-up, risk of deterioration of the doctor-patient relationship, and insincerity on the part of the patient. Additionally, cultural aspects of violence, uncertainty/helplessness, fear, lack of competence and qualifications, autonomy/negative experience, and passive role/stigma/fear on the part of the patients were barriers to active detection.ConclusionAll the participating doctors had had previous experience with active detection of IPV and were aware of its importance. Due to several barriers to screening for violence they preferred active detection.

Barriers to Screening and Possibilities for Active Detection of Family Medicine Attendees Exposed to Intimate Partner Violence

Community Health Centre Ljubljana, Metelkova 9, 1000 Ljubljana,

University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000 Ljubljana,

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

OVIRE ZA PRESEJANJE ZA NASILJE IN MOŽNOSTI DEJAVNEGA ODKRIVANJA OSEB Z IZKUŠNJO NASILJA V PARTNERSKIH ODNOSIH V DRUŽINSKI MEDICINI

IntroductionIn 1996 the World Health Organization declared intimate partner violence (IPV) the most important public health problem. Meta-analyses in 2013...

	Barriers	Incentives
Healthcare system/organisation of work	• lack of time/complexity	• awareness of the position/role of the family practitioner
	• organisation and finances
Doctor	• cultural aspects of violence	• awareness of the importance of active detection of cases
	• uncertainty/helplessness/fear
	• lack of competence and qualifications	• positive effects of the disclosure of violence
	• impact of the disclosure on the patient-doctor relationship
Patient	• patient autonomy, negative - experience	• the need to trust
	• passive role, tolerance, stigma, fear

	Barriers	Incentives
Healthcare system/organisation of work	• lack of time	• method of implementation and possibilities of a team approach
	• staff turnover
	• inadequate financing
Doctor	• ignorance of a clear definition	• awareness of the detecting violence
	• poor commitment to screening
	• obligation to follow up
	• risk of deterioration of the doctor-patient relationship
Patient	• insincerity

Barriers to Screening and Possibilities for Active Detection of Family Medicine Attendees Exposed to Intimate Partner Violence

Article Category: Original scientific article

Publicado en línea: 10 mar 2016

Páginas: 11 - 20

Recibido: 23 abr 2015

Aceptado: 04 ago 2015

DOI: https://doi.org/10.1515/sjph-2016-0002

Palabras clave
domestic violence, qualitative research, mass screening, early diagnosis/early detection

© National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Results of qualitative analysis: barriers to active detection of violence.

Barriers to screening for intimate partner violence.

Barriers to Screening and Possibilities for Active Detection of Family Medicine Attendees Exposed to Intimate Partner Violence

Article Category: Original scientific article

Publicado en línea: 10 mar 2016

Páginas: 11 - 20

Recibido: 23 abr 2015

Aceptado: 04 ago 2015

DOI: https://doi.org/10.1515/sjph-2016-0002

Palabras clavedomestic violence, qualitative research, mass screening, early diagnosis/early detection

© National Institute of Public Health, Slovenia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Results of qualitative analysis: barriers to active detection of violence.

Barriers to screening for intimate partner violence.

Palabras clave
domestic violence, qualitative research, mass screening, early diagnosis/early detection