title: Tensions and Ambivalent Feelings: Opinions of Emergency Department Employees About the Identification and Management of Intimate Partner Violence.
abstract: The objective of this study was to examine factors facilitating and constraining the identification and management of intimate partner violence (IPV) at an emergency department (ED). Semi-structured interviews were conducted with 18 ED employees of a university hospital in the Netherlands. All interviews were audiotaped, transcribed verbatim, and analyzed by using qualitative content analysis in Atlas.ti. Constraining factors were lack of knowledge, awareness, and resources at the ED. ED employees felt many barriers to bringing up IPV. Facilitating factors were good cooperation among staff, the involvement of one team member in producing an IPV protocol, having received training on child abuse, and private consulting rooms. The ED setting and the ED employees' task perception and attitude contained both constraining and facilitating factors: ED employees saw it as their task and responsibility to help IPV victims, but their priorities were to secure a high turnover and treat acute physical problems. Although ED employees expressed openness and willingness to help, they also took the view that victims had a considerable responsibility of their own in disclosing and managing IPV, which led to ambivalent feelings. In conclusion, ED employees faced tensions in IPV identification and management caused by lack of awareness, knowledge and resources, conflicting priorities at the ED, and ambivalent feelings. Improvements can be made by supporting ED employees with guidelines in the form of a protocol and with training that also addresses the tensions ED employees face.
authors.affiliation: 1 Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Elza
authors.initials: E
authors.lastname: Zijlstra
authors.affiliation: 1 Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Rik
authors.initials: R
authors.lastname: van de Laar
authors.affiliation: 1 Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Marie Louise
authors.initials: ML
authors.lastname: Moors
authors.affiliation: 1 Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lo Fo Wong
authors.affiliation: 1 Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Antoine
authors.initials: A
authors.lastname: Lagro-Janssen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000706:statistics & numerical data*; D030881:Disclosure; D004636:Emergency Service, Hospital; D004644:Emotions; D005069:Evaluation Studies as Topic; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007407:Interviews as Topic; D000066511:Intimate Partner Violence / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D013179:Spouse Abuse / Q000175:diagnosis*
keywords: battered women; disclosure of domestic violence; domestic violence; intervention/treatment; perceptions of domestic violence