"I Can Remember Thinking, Like Almost Wishing, That the Injuries Would Have Been Worse, Because Then I Wouldn't Be Questioned": A Qualitative Study on Women's Experience of Accessing Healthcare for Intimate Partner Violence-Related Brain Injury

“我记得当时我几乎是希望伤势更严重一些,因为那样我就不会被盘问了”:一项关于女性因亲密伴侣暴力导致脑损伤而获得医疗保健经历的定性研究

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Abstract

Background/Objectives: To identify the barriers and facilitators to accessing healthcare following intimate partner violence (IPV)-related brain injury (BI). Methods: Sixteen adult women participated in interviews about their experience of accessing healthcare following IPV-related BI. Interviews were transcribed verbatim and analyzed using the interpretative descriptive (ID) approach to identify themes and subthemes in the data. Results: Two themes, each with six subthemes related to healthcare seeking for IPV-related BI were identified: Theme 1-Deciding to seek and ability to access healthcare, comprising (a) severity of injury; (b) impact of injury; (c) ability to access medical services; (d) self-blame, fear, shame, and guilt; (e) contextual influences on healthcare seeking; and (f) previous negative interactions; and Theme 2-Complexity in identifying IPV-related BI, comprising (a) trauma can affect recall of events; (b) inability to distinguish IPV-related trauma or aging outcomes from BI sequelae; (c) the importance of trust in disclosure; (d) healthcare professionals need to ask the right questions and respond in the right way; (e) the complex nature of disclosure creates challenges for diagnosis; and (f) fear of being dismissed or judged. Conclusions: Many context-related factors influence whether women can seek treatment for IPV-related BIs. These factors need to be understood by first responders and medical professionals to improve the likelihood and speed of treatment seeking. Furthermore, challenges and fears associated with disclosure of IPV prevent women from seeking proper treatment. IPV training could be helpful in ensuring women feel safe with disclosure.

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