Domestic violence leads to multiple health problems in victims and their families. Family doctors are in a particularly privileged position to detect, follow up, refer and report cases of domestic ...violence. However, little is known about the perception of these physicians regarding their role in managing domestic violence cases.
We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews were audio recorded, transcribed, and analysed using thematic analysis.
Fifty-four family doctors participated in this study (n = 39 women, n = 15 men). The themes and subthemes that emerged from the data analysis translated doctors' broad responsibilities when approaching victims and aggressors. These included: "Implement preventive measures", "Empower the victim leading them to recognize the violent situation", "Detect domestic violence cases", "Treat health problems related to violence", "Provide emotional support", "Refer victims to specialized services", "Register the episode on the victims and/or aggressor clinical records", "Incentivize the victim to report", "Report the case to the authorities", "Intervene with the aggressor", "Protect other individuals" and "Follow up the patient and the process".
The results of this study provide an overview of the current practical approaches being adopted by physicians and may provide a base for developing new interventions to support physicians to manage cases of domestic violence.
Domestic violence (DV) is a serious and prevalent public health problem with devastating consequences for the victims and their families. Whilst the number of cases reported to the authorities has ...risen in recent years, many victims still chose not to present a complaint. In Portugal, to address this, DV became a public crime. As victims of DV present multiple health problems and frequently seek professional help, family doctors are in a privileged position to detect and report cases of DV to the authorities. However, little is known about what motivates these professionals to report or not the DV cases they encounter in their practice to the authorities.
We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews occurred between July 2020 and September 2022, were conducted in person or remotely, audio recorded, transcribed, and analysed using thematic analysis. Content analysis was conducted to assess the agreement or disagreement regarding mandatory reporting in each of the themes and subthemes.
Fifty-four family doctors took part in this study (n = 39 women, n = 15 men). The main themes that arose from the analysis were: "Barriers related to the physician's activity," "Barriers related to the victim or aggressor," "Facilitators related to the physician's activity," "Facilitators related to the victim or aggressor." Although different barriers were described, most doctors agreed with the mandatory reporting of DV cases.
Family doctors encounter multiple barriers and facilitators when considering reporting a DV case to the authorities. The results of this study can help develop new interventions to address the barriers described by the doctors, increasing their compliance with mandatory reporting, the protection of victims and the just persecution of the aggressor.
Intimate Partner Violence (IPV) is a global pandemic and many have been victims of it long before Covid-19. International organizations have documented an increase in IPV reports during the current ...pandemic, raising awareness of the potential causes for such an increase. Reflecting on risk factors associated with IPV, and the underlying need of the perpetrators to exert control over the victims, it becomes increasingly important to understand how the current policies of social distancing, self-isolation, and lockdown can precipitate episodes of IPV. Furthermore, access to specialized services and health care can be compromised, and health care professionals face new challenges and demands imposed by the pandemic while managing IPV cases. This article begins by examining the main risk factors more commonly associated with IPV in the literature. It proceeds by reflecting on how these risk factors may be exacerbated during the Covid-19 pandemic, which can explain the increased number of reports. Finally, it emphasizes the new challenges faced by health care professionals, while assisting IPV victims during the pandemic and provides possible recommendations on actions to implement during and beyond the Covid-19 pandemic to prevent such cases.
•Intimate Partner Violence cases increase during emergencies.•An increase in IPV cases has been reported during the Covid-19 pandemic.•IPV has been related to numerous risk factors.•Risk factors for IPV can be exacerbated during the Covid-19 pandemic.•Health care professionals face new challenges managing IPV cases during the Covid-19 pandemic.
Abstract
Background
Domestic violence has been addressed in public policies and law reforms in many countries to target its identification and provide increased support to those affected. In some ...countries, reporting domestic violence is mandatory, which means that anyone not only ‘can’ but also ‘must’ file a report, which is enough to progress the criminal proceedings, even against the victim’s will. This article provides an overview about the importance of the clinicians’ duty of care, debating whether or not domestic violence should be a public crime.
Methods
A narrative review on the subject of mandatory reporting of domestic violence, conducting a search of PubMed.
Results
Twenty studies were retrieved. Commonly victims agree with mandatory reporting. However, there are still several concerns voiced by both victims and health care workers that need to be further addressed.
Conclusion
This article addresses the importance and limitations of mandatory reporting while acknowledging the impact of these measures in both the victim and the accused.
Introdução:A Violência Doméstica (VD) é um problema de saúde pública grave, prevalente e com consequências devastadoras para as vítimas e as suas famílias. O número de denúncias de VD às autoridades ...tem vindo a aumentar nos últimos anos. No entanto, muitas vítimas optam por não denunciar. Com vista a aumentar o número de denúncias, promovendo a proteção das vítimas e a persecução dos agressores, a VD tornou-se crime público em Portugal. As vítimas de VD apresentam múltiplos problemas de saúde e procuram frequentemente ajuda profissional. Os médicos de Medicina Geral e Familiar (MGF) encontram-se numa posição privilegiada para a deteção e denúncia de casos de VD às autoridades. No entanto, pouco se sabe sobre o que motiva estes profissionais a apresentar, ou não, uma denúncia às autoridades de casos de VD de que tenham conhecimento no exercer das suas funções.Objetivos:Averiguar a opinião dos médicos especialistas em MGF sobre a obrigatoriedade de denúncia da VD, o seu papel na gestão de casos de VD, e quais os fatores que constituem barreiras ou facilitadores da apresentação de denúncia às autoridades.Metodologia:Foram conduzidas entrevistas semiestruturadas a médicos especialistas em MGF das Administrações Regionais de Saúde de Portugal Continental. Estas entrevistas foram realizadas presencialmente ou por videoconferência e foram áudiogravadas, transcritas e posteriormente analisadas com recurso à técnica de análise temática. Foi feita a análise de conteúdo para determinar se os temas e subtemas encontrados se relacionavam com a concordância ou discordância dos profissionais de saúde em relação à legislação em vigor.Resultados:Cinquenta e quatro médicos aceitaram participar neste estudo (n=39 mulheres, n=15 homens). Os principais temas que surgiram da análise temática foram “Papel do médico”, “Barreiras à denúncia relacionadas com a atividade médica”, “Barreiras à denúncia relacionadas com a vítima e/ou agressor”, “Facilitadores de denúncia relacionados com a atividade médica” e “Facilitadores de denúncia relacionados com a vítima e/ou agressor”. A maioria dos médicos concorda com a obrigatoriedade de denúncia, ainda que muitas barreiras tenham sido apresentadas.Conclusões:Os médicos encaram a sua intervenção na gestão dos casos de VD de uma forma abrangente, assumindo múltiplos papéis no seguimento dos seus utentes, antes e após a apresentação de uma denúncia às autoridades. A apresentação, ou não, de uma denúncia é motivada pela interação entre múltiplas barreiras e facilitadores, que condicionam a posição dos médicos face à legislação em vigor. Os resultados deste estudo podem incentivar o desenvolvimento de novas intervenções na área da VD, quer a nível de investigação, quer no que diz respeito ao desenvolvimento de novas medidas sociais e legislativas.
Objective: This study aimed to analyze the experiences of victims of violence in intimate relationships (VIRs) who remain in, return to, or abandon the abusive relationship, as well as examine the ...type of violence suffered, the existing symptoms, and the motivation to change as explained by the Transtheoretical Model of Change. Method: The participants were 38 victims, three males and 35 females, who completed an online questionnaire comprising a section on sociodemographic data, and three instruments, the Self-Reporting Questionnaire 20 (SRQ-20), Marital Violence Inventory (MVI), and the University of Rhode Island Change Assessment (URICA). Results: Data analysis has shown that psychological violence was the type of violence most frequently experienced followed by physical and verbal violence, the house of the victims was the local where the violence mostly took place, the help-seeking behaviors were mostly directed to the family and attempts to leave from the abusive relationship is related to the experience of family violence in childhood. Participants were all in the action stage of the change, but aggressor's expectation/promise to change, the existence of children and maintaining the family or marriage, as well as economic difficulties are the main factors that contribute to both remaining in, or returning to, the abusive relationship. Conclusion: We will reflect on the social, clinical, and legal implications for the future of research with victims of VIR.
Clinical Impact Statement
Domestic violence in intimate relationships is a public health problem. The experience of an abusive relationship is very harmful to the victim, and can negatively affect their physical and psychological. Not all victims recognize that they are being victims, so it is important to prepare them for change, giving victims tools to leave the abusive relationship or seek help for the violence to end.
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