Health needs and barriers to healthcare of women who have experienced intimate partner violence.
BACKGROUND
This study assessed the health needs and barriers to healthcare among women with a history of intimate partner violence (IPV) as told by women themselves.


METHODS
Qualitative interviews were conducted with 25 women clients and 10 staff members at a crisis center in metropolitan North Carolina. Clients also completed a structured survey.


RESULTS
Eleven shelter clients and 14 walk-ins completed the survey and interview. Client participants were demographically mixed, and 20% were Spanish-speaking immigrants. Most clients were unemployed and uninsured. Women reported worse health in the interviews than on the surveys; clients' major health needs were chronic pain, chronic diseases, and mental illness. Reported barriers to healthcare were cost, psychological control by the abuser, and low self-esteem and self-efficacy. Staff's perceptions of clients health needs differed from clients,' focusing on reproductive health, HIV/sexually transmitted infection (STI), mental illness, and inadequate preventive healthcare. Staff and clients' perceptions of barriers to healthcare were more congruent. Suggestions for improving the center's response were to offer more health education groups and more health-related staff trainings. Agency barriers to implementing these changes were limited funding, focus on crisis management, and perceived disconnect with the healthcare system.


CONCLUSIONS
Health needs of women who have experienced IPV are significant and include physical and mental concerns. IPV creates unique barriers to accessing healthcare, which can be addressed only partially by a crisis center. Greater coordination with the healthcare system is needed to respond more appropriately to the health needs of women who have experienced IPV.
Division of Community Health, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA. weisiting@hotmail.com
Kate S
KS
Wilson
Mina R
MR
Silberberg
Ann J
AJ
Brown
Susan D
SD
Yaggy
D000328:Adult; D018585:Battered Women / Q000523:psychology*; D003144:Communication Barriers; D003376:Counseling / Q000379:methods*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D009657:North Carolina; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods; D010817:Physician-Patient Relations; D012649:Self Concept; D013179:Spouse Abuse / Q000517:prevention & control / Q000523:psychology*; D011795:Surveys and Questionnaires