Article Text

Original research
Women’s experiences and expectations after disclosure of intimate partner abuse to a healthcare provider: A qualitative meta-synthesis
  1. Laura Tarzia1,2,
  2. Meghan A Bohren3,
  3. Jacqui Cameron1,
  4. Claudia Garcia-Moreno4,
  5. Lorna O'Doherty1,5,
  6. Renee Fiolet1,
  7. Leesa Hooker6,
  8. Molly Wellington1,
  9. Rhian Parker1,
  10. Jane Koziol-McLain7,
  11. Gene Feder8,
  12. Kelsey Hegarty1,2
  1. 1 Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2 Centre for Family Violence Prevention, The Royal Women’s Hospital, Parkville, Victoria, Australia
  3. 3 Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Department of Reproductive Health and Research, WHO, Geneva, Switzerland
  5. 5 Centre for Research in Psychology, Behaviour and Achievement, Coventry University, Coventry, UK
  6. 6 Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
  7. 7 Centre for Interdisciplinary Trauma Research, Auckland University of Technology, Auckland, New Zealand
  8. 8 School of Social and Community Medicine, University of Bristol, Bristol, UK
  1. Correspondence to Dr Laura Tarzia; laura.tarzia{at}unimelb.edu.au

Abstract

Objective To identify and synthesise the experiences and expectations of women victim/survivors of intimate partner abuse (IPA) following disclosure to a healthcare provider (HCP).

Methods The databases MEDLINE, Embase, CINAHL, PsychINFO, SocINDEX, ASSIA and the Cochrane Library were searched in February 2020. Included studies needed to focus on women’s experiences with and expectations of HCPs after disclosure of IPA. We considered primary studies using qualitative methods for both data collection and analysis published since 2004. Studies conducted in any country, in any type of healthcare setting, were included. The quality of individual studies was assessed using an adaptation of the Critical Appraisal Skills Programme checklist for qualitative studies. The confidence in the overall evidence base was determined using Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-Confidence in the Evidence from Reviews of Qualitative Research methods. Thematic synthesis was used for analysis.

Results Thirty-one papers describing 30 studies were included in the final review. These were conducted in a range of health settings, predominantly in the USA and other high-income countries. All studies were in English. Four main themes were developed through the analysis, describing women’s experiences and expectations of HCPs: (1) connection through kindness and care; (2) see the evil, hear the evil, speak the evil; (3) do more than just listen; and (4) plant the right seed. If these key expectations were absent from care, it resulted in a range of negative emotional impacts for women.

Conclusions Our findings strongly align with the principles of woman-centred care, indicating that women value emotional connection, practical support through action and advocacy and an approach that recognises their autonomy and is tailored to their individual needs. Drawing on the evidence, we have developed a best practice model to guide practitioners in how to deliver woman-centred care. This review has critical implications for practice, highlighting the simplicity of what HCPs can do to support women experiencing IPA, although its applicability to low-income and-middle income settings remains to be explored.

  • qualitative research
  • public health
  • quality in healthcare
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Footnotes

  • Twitter @DrLauraTarzia, @JacquiCameron18, @leesahoo

  • Contributors LT led study design, data collection and data analysis, and wrote the first and subsequent drafts of the manuscript. MB participated in the study design and data collection and commented on all drafts. JC participated in the data collection, led the quality appraisal and Confidence in the Evidence from Reviews of Qualitative Research process, and contributed to drafting the manuscript. LH and RF made significant contributions to study design and data collection. LOD, RP and MW contributed significantly to the data collection and quality appraisal. CG-M contributed to the study conception, study design and data analysis. GF and JK-M contributed to the study conception and study design. KH led the study conception and contributed to the study design and data analysis and commented on all drafts. All authors read and commented on the final draft of the manuscript and approved it for publication. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Funding This review was supported by the National Health and Medical Research Council through the Centre for Research Excellence in Safer Families (APP1116690). The funding body played no role in the study design; the collection, analysis and interpretation of data; writing of the report; or the decision to submit the article for publication.

  • Competing interests None declared.

  • Patient and public involvement statement It was not appropriate or possible to involve patients or the public in the design or conduct of this research; however, we plan to involve them in the dissemination and implementation of the findings.

  • Patient consent for publication Not required.

  • Ethics approval As a review and metasynthesis of existing studies, ethics approval was not required for this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.