Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Nursing

Supervisor

Ford-Gilboe, Marilyn

Abstract

Functional gastrointestinal disorders (FGIDs) and symptoms have been identified as possible health consequences of intimate partner violence (IPV). However, whether specific types of abuse (i.e., psychological, physical and sexual) affect the health of women in different ways, and the mechanisms that explain how these forms of abuse affect their health and quality of life are not well understood. The aims of this systematic review were to examine the association between the different types of IPV and the risk of FGIDs and symptoms among adult women, identify the factors that mediate and/or moderate these health effects, and assess the impact of FGIDs and symptoms on women’s quality of life. Seven electronic databases were searched using the following criteria: English language studies of adult women (15 years or older) who had experienced IPV and reported FGIDs and symptoms; both quantitative descriptive (i.e., ecological, cross-sectional, cohort, and case-control studies) and qualitative studies were included, and no time frame for publication was specified. A quality assessment of each included study was completed using either published guidelines from Hoya et al. (2012) for quantitative studies or the Critical Skills Appraisal Program (CASP; 2010) tool for qualitative studies. A total of 15 studies satisfied our inclusion criteria. Results suggest that there is an association between various types of IPV and FGIDs and symptoms but none of the included studies examined factors that might mediate and/or moderate this association. Further, limited attention was given to examining the association of FGIDs and quality of life (QOL) in the context of IPV. The findings of this study emphasize the importance of adapting nursing practice, education, and research to improve care for women who have experienced IPV and are suffering from FGIDs.

Summary for Lay Audience

Intimate partner violence (IPV) is consistently associated with a broad range of adverse health outcomes and functional gastrointestinal disorders (FGIDs) are considered to be one of the long-term negative health outcomes. FGIDs are common disorders characterized by persistent and recurring gastrointestinal (GI) symptoms that are not caused by structural (e.g., tumours or masses) or biochemical abnormalities. FGIDs are considered to be the most common diagnosis in gastroenterology. Women with FGIDs appear to access health care services more frequently than men and women without FGIDs.

The literature shows that there is a significant world-wide prevalence of FGIDs among women who have experienced IPV and that FGIDs negatively affect women's quality of life outcomes. A systematic review was conducted to identify some critical gaps in specific areas where the evidence is unclear. The purposes of this systematic review were to: a) examine the association between different types of IPV (i.e., physical, sexual, and psychological abuse) and the risk of FGIDs and symptoms among adult women; b) identify the factors that might mediate or moderate these health effects; and, c) examine how FGIDs affect aspects of women’s QOL (e.g., health, social life, and economic status).

Overall, we found that there is a positive association between IPV and FGIDs. The results also show that there is a lack of theory-driven investigation into the mechanisms that mediate and/or moderate this relationship. Additionally, among the included studies, limited attention was given to examining FGIDs and quality of life (QOL) in the context of IPV. These findings may provide direction for nursing practice in women’s health and suggest priorities for future research.

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