title: Experience of abuse in primary care patients. Racial and rural differences.
abstract: OBJECTIVE
  To examine the experience of abuse in rural, urban, black, and white women on the following dimensions: prevalence, symptom experience, health status, medical services utilization, and coping mechanisms.
  
  
  METHODS
  Retrospective study using patient interviews.
  
  
  METHODS
  Half the subjects were recruited from a large medical university family medicine center and half from a rural family medicine center, both in the Southeast.
  
  
  METHODS
  Four hundred seven women were interviewed. Groups were distributed as follows: urban white, 24.9% (n = 99); urban black, 25.6% (n = 102); rural white, 11.1% (n = 44); and rural black, 38.4% (n = 153).
  
  
  METHODS
  Self-report of abuse (sexual, physical, and emotional) was related to symptom history, current health status, medical services utilization, and coping styles.
  
  
  RESULTS
  Sixty-six percent of the total sample reported some kind of abuse. Black, rural women reported the least (52.3%). Presence of greater numbers of symptoms, greater medical services utilization, and lower health status were found in the abused population. Abused women used all types of coping mechanisms to a greater extent than non-abused women. Black women were more likely to use confrontation (F = 8.82 [P = .003]), problem solving (F = 8.24 [P = .004]), and reappraisal (F = 4.13 [P = .04]) than white women. Rural women were more likely to use psychological distancing (F = 5.25 [P = .02]) and escape (F = 5.67 [P = .02]) than urban women, although abused women in general use those coping methods more than nonabused women.
  
  
  CONCLUSIONS
  The experience of abuse remains similar across black, white, rural, and urban women; however, coping mechanisms appear to be influenced by group membership.
authors.affiliation: Department of Family Medicine, Medical College of Georgia, Augusta, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Wagner
authors.forename: P
authors.initials: P
authors.lastname: Mongan
authors.forename: D
authors.initials: D
authors.lastname: Hamrick
authors.forename: L K
authors.initials: LK
authors.lastname: Hendrick
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D015995:Prevalence; D012189:Retrospective Studies; D012423:Rural Health / Q000706:statistics & numerical data*; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*