title: Classificatory multiplicity: intimate partner violence diagnosis in emergency department consultations.
abstract: OBJECTIVE
  To explore the naming, or classification, of physical assaults by a partner as 'intimate partner violence' during emergency department consultations.
  
  
  BACKGROUND
  Research continues to evidence instances when intimate partner physical violence is 'missed' or unacknowledged during emergency department consultations.
  
  
  METHODS
  Theoretically, this research was approached through complexity theory and the sociology of diagnosis. Research design was an applied, descriptive and explanatory, multiple-method approach that combined qualitative semistructured interviews with service-users (n = 8) and emergency department practitioners (n = 9), and qualitative and quantitative document analysis of emergency department health records (n = 28).
  
  
  RESULTS
  This study found that multiple classifications of intimate partner violence were mobilised during emergency department consultations and that these different versions of intimate partner violence held different diagnostic categories, processes and consequences.
  
  
  CONCLUSIONS
  The construction of different versions of intimate partner violence in emergency department consultations could explain variance in people's experiences and outcomes of consultations. The research found that the classificatory threshold for 'intimate partner violence' was too high. Strengthening systems of diagnosis (identification and intervention) so that all incidents of partner violence are named as 'intimate partner violence' would reduce the incidence of missed cases and afford earlier specialist intervention to reduce violence and limit its harms.
  
  
  CONCLUSIONS
  This research found that identification of and response to intimate partner violence, even in contexts of severe physical violence, was contingent. By lowering the classificatory threshold so that all incidents of partner violence are named as 'intimate partner violence', practitioners could make a significant contribution to reducing missed intimate partner violence during consultations and improving health outcomes for this population. This research has relevance for practitioners in any setting where service-user report of intimate partner violence is possible.
authors.affiliation: College of Health and Wellbeing, University of Central Lancashire, Preston, UK.
authors.forename: Philippa
authors.identifier: http://orcid.org/0000-0002-9175-1285
authors.initials: P
authors.lastname: Olive
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D000066511:Intimate Partner Violence / Q000517:prevention & control* / Q000523:psychology; D012017:Referral and Consultation; D013222:State Medicine; D014932:Women's Health Services
keywords: accident and emergency; classification; diagnosis; domestic violence; emergency care; emergency department; health service research; intimate partner violence; sociology; violence against women