title: Attitudes towards domestic violence in Lebanon: a qualitative study of primary care practitioners.
abstract: BACKGROUND
  Domestic violence (DV) is highly prevalent in the developing and developed world. Healthcare systems internationally are still not adequately addressing the needs of patients experiencing violence.
  
  
  OBJECTIVE
  To explore physicians' attitudes about responding to DV, their perception of the physician's role, and the factors that influence their response.
  
  
  METHODS
  Qualitative study using individual interviews among primary care practitioners working in Lebanon.
  
  
  METHODS
  Primary care clinicians practising for >5 years and with >100 patient consultations a week were interviewed. Physicians were asked about their practice when encountering women disclosing abuse, their opinion about the engagement of the health services with DV, their potential role, and the anticipated reaction of patients and society to this extended role.
  
  
  RESULTS
  Physicians felt that they were well positioned to play a pivotal role in addressing DV; yet they had concerns related to personal safety, worry about losing patients, and opposing the norms of a largely conservative society. Several physicians justified DV or blamed the survivor rather than the perpetrator for triggering the violent behaviour. Moreover, religion was perceived as sanctioning DV.
  
  
  CONCLUSIONS
  Perceived cultural norms and religious beliefs seem to be major barriers to physicians responding to DV in Lebanon, and possibly in the Arab world more generally. Financial concerns also need to be addressed to encourage physicians to address DV.
authors.affiliation: Department of Family Medicine, American University of Beirut, Lebanon, Beirut.
authors.forename: Jinan
authors.initials: J
authors.lastname: Usta
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Gene
authors.initials: G
authors.lastname: Feder
authors.affiliation: Department of Family Medicine, American University of Beirut, Lebanon, Beirut.
authors.forename: Jumana
authors.initials: J
authors.lastname: Antoun
mesh_terms: D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel / Q000208:ethnology*; D003466:Cultural Characteristics; D003906:Developing Countries; D017579:Domestic Violence / Q000517:prevention & control* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D036301:Qualitative Research; D018570:Risk Assessment; D012737:Sex Factors
keywords: Arab world; Lebanon; attitude; domestic violence; primary health care