Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Dr. Joy MacDermid

Abstract

Intimate Partner Violence (IPV) can have a lasting impact on survivors’ emotional, physical, and psychological wellbeing. IPV is multifaceted and can influence survivors’ interactions across various institutions, including healthcare settings. This PhD project consists of both qualitative and quantitative studies aimed at exploring the clinical and societal perspectives around IPV.

Study #1 sought to explore the discourses around male IPV drawn from a social networking site (Reddit.com). While some areas related to IPV are well researched, studies on male intimate partner violence survivors are limited. The results from study #1 show that male IPV disclosure is a complex process. While some negative responses are present, overall, the responses to disclosure are positive. In addition, the study revealed multiple perceived systemic issues that negatively impact male IPV survivors.

Study #2 examined clinicians’ experiences (attitudes and perceptions regarding IPV and IPV assessment). Findings from previous research indicate musculoskeletal (MSK) injuries are the second most common trauma. As such, it is an important topic for hand therapists (HTs). The study findings show that while HTs agree dealing with IPV is part of their job responsibilities (3.8/5) they reported a neutral level of self-efficacy (2.9/5), perceived system support (3/5), and victim provider safety (3/5). Furthermore, findings indicate that majority of HTs (66%) reported that they had not assessed for IPV in the past 3 months.

Fear of offending the patient was identified from study #2 as being one of the barriers to screening for IPV. As such, study #3 sought explore patient attitudes regarding IPV inquiry in an upper limb extremity clinic. The findings indicate a majority of patients felt that neither they nor other people would be offended by IPV inquiry. However, a substantial minority felt that other people would be offended by IPV inquiry.

The results of this PhD project have implications for both rehabilitation practice and further research. Public awareness programs aimed at society, clinicians, and policy makers is imperative for fostering an environment in which conversations around male IPV victimization can take place without shame or stigma. Additionally, the results indicate the need to evaluate currently available services to males who have disclosed their sexual abuse histories to ensure their needs are effectively met. Further research on IPV assessment in the rehabilitation context is needed to ensure that needs of both male and female IPV survivors are adequately met.

Summary for Lay Audience

Summary of Study #1 (Chapters 2-3): Web-Based Discourses around IPV in Reddit: a qualitative analysis

We have learned a lot about what happens when women experience violence from their partners. But we still do not know very much about what it is like for men who are abused by their partners. This study used postings on social networking sites (SNSs) to understand how people talked about violence against men by their partners. Chapter 2 looked at postings on reddit.com where the content included 1) men telling other people about being abused by their partner, and/or 2) how people responded when men said they had experienced violence from a partner. The study in Chapter 3 examined all postings that talked about the abuse of men by their partners and looked for all examples of bias or mistreatment by services and agencies that were supposed to help people in these situations.

Summary of Study #2 (Chapter 4-5): Survey of Intimate Partner Violence Preparedness and Practices Amongst Hand Therapists

We know that musculoskeletal (MSK) injuries including upper extremity sprains and fractures are common amongst victims of intimate partner violence. While we know about the attitudes of nurses, physicians, surgeons and students and other clinicians in regard to IPV, we don’t know very much about HTs, who specialize in rehabilitation of MSK related injuries. Study #2 was a survey designed to examine HTs’ attitudes and perceptions regarding IPV and their ability to deal with clients who may have IPV experience in their clinical setting. Chapter 4 looked at HTs’ perceptions of self-efficacy, available system support, victim blaming attitudes, whether HTs believed dealing with IPV was part of their job responsibility, and whether HTs perceived they could safely deal with IPV in their clinic. Meanwhile, Chapter 5 examined the assessment and response to IPV amongst HTs.

Summary of Study #3 (Chapter 6): An Anonymous Survey of Patients’ Screening Attitudes

Previous studies, including those published in this thesis, have found one of the barriers to screening for IPV amongst clinicians is fear of offending the patients. Study #3 looked at whether patients would be offended if their clinicians assessed patients for IPV. The quantitative study used a survey to examine if patients might be embarrassed by inquiry regarding IPV amongst patients visiting an upper extremity specialty clinic.

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