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Abused Women Disclose Partner Interference with Health Care: An Unrecognized Form of Battering

  • Laura A. McCloskey
  • Corrine M. Williams
  • Erika Lichter
  • Megan Gerber
  • Michael L. Ganz
  • Robert Sege
Original Article

Abstract

BACKGROUND

Some providers observe that partners interfere with health care visits or treatment. There are no systematic investigations of the prevalence of or circumstances surrounding partner interference with health care and intimate partner violence (IPV).

OBJECTIVE

To determine whether abused women report partner interference with their health care and to describe the co-occurring risk factors and health impact of such interference.

DESIGN

A written survey of women attending health care clinics across 5 different medical departments (e.g., emergency, primary care, obstetrics–gynecology, pediatrics, addiction recovery) housed in 8 hospital and clinic sites in Metropolitan Boston.

PARTICIPANTS

Women outpatients (N = 2,027) ranging in age, 59% White, 38% married, 22.6% born outside the U.S.

MEASUREMENT

Questions from the Severity of Violence and Abuse Assessment Scale, the SF-36, and questions about demographics.

RESULTS

One in 20 women outpatients (4.6%) reported that their partners prevented them from seeking or interfered with health care. Among women with past-year physical abuse (n = 276), 17% reported that a partner interfered with their health care in contrast to 2% of women without abuse (adjusted odds ratios [OR] = 7.5). Further adjusted risk markers for partner interference included having less than a high school education (OR = 3.2), being born outside the U.S. (OR = 2.0), and visiting the clinic with a man attending (OR = 1.9). Partner interference raised the odds of women having poor health (OR = 1.8).

CONCLUSIONS

Partner interference with health care is a significant problem for women who are in abusive relationships and poses an obstacle to health care. Health care providers should be alert to signs of patient noncompliance or missed appointments as stemming from abusive partner control tactics.

KEY WORDS

intimate partner violence partner interference with health care abused women domestic violence women’s health 

Notes

Acknowledgments

The research was supported with a grant to the first author from the Agency for Healthcare Research Quality (AHRQ R01-HS1-1088).

Conflicts of Interest

None disclosed.

References

  1. 1.
    Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, Smith PH. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. 2002;23(4):260–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Abbott J, Johnson R, Koziol-McLain J, Lowenstein SR. Domestic violence against women: incidence and prevalence in an emergency department population. JAMA. 1995;273:1763–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Ernst AA, Nick TG, Weiss SJ, Houry D, Mills T. Domestic violence in an inner-city ED. Ann Emerg Med. 1997;30:190–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Rhodes KV, Lauderdale DS, He T, Howes DS, Levinson W. Between me and the computer: increased detection of intimate partner violence using a computer questionnaire. Ann Emerg Med. 2002;40:476–84.PubMedCrossRefGoogle Scholar
  5. 5.
    McCloskey LA, Lichter E, Ganz ML, Williams CM, Gerber MR, Sege R, Stair T. Intimate partner violence in women patients across medical specialties. Acad Emerg Med. 2005;12(8):1–11.CrossRefGoogle Scholar
  6. 6.
    American Medical Association. Diagnostic and Treatment Guidelines on Domestic Violence. Chicago, IL: American Medical Association; 1994.Google Scholar
  7. 7.
    Campbell JC. Health consequences of intimate partner violence. Lancet. 2002;359(9314):1331–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Campbell J, Jones AS, Dienemann J, Kub J, Schollenberger J, O'Campo P, et. al. Intimate partner violence and physical health consequences. Arch Intern Med. 2002;162:1157–63.PubMedCrossRefGoogle Scholar
  9. 9.
    Tolman RM, Rosen D. Domestic violence in the lives of women receiving welfare: mental health, substance dependence and economic well-being. Violence Against Women. 2001;7:141–58.Google Scholar
  10. 10.
    Meisel J, Chandler D, Rienze BM. Domestic violence prevalence and effects on employment in two California TANF populations. Violence Against Women. 2003;9:1191–212.CrossRefGoogle Scholar
  11. 11.
    Riger S, Staggs SL, Schewe P. Intimate partner violence as an obstacle to employment among mothers affected by welfare reform. J Soc Issues. 2004;60:801–18.CrossRefGoogle Scholar
  12. 12.
    Swanberg JE, Logan TK. Domestic violence and employment: a qualitative study. J Occup Health Psychol. 2005;10(1):3–17.PubMedCrossRefGoogle Scholar
  13. 13.
    Dietz PM, Gazmararian JA, Goodwin MM, Bruce FC, Johnson CH, Rochat RW. Delayed entry into prenatal care: effect of physical violence. Obstet Gynecol. 1997;90(2):221–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Taggart L, Mattson S. Delay in prenatal care as a result of battering in pregnancy: cross-cultural implications. Health Care Women Int. 1996;17(1):25–34.PubMedCrossRefGoogle Scholar
  15. 15.
    Marshall LL. Development of the severity of violence against women scales. J Fam Violence. 1992;7:103–21.CrossRefGoogle Scholar
  16. 16.
    McFarlane J, Greenberg L, Weltge A, Watson M. Identification of abuse in emergency departments: effectiveness of a two-question screening tool. J Emerg Nurs. 1995;21:391–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Lown EA, Vega WA. Intimate partner violence and health: self-assessed health, chronic health, and somatic symptoms among Mexican American women. Psychosom Med. 2001;63(3):352–60.PubMedGoogle Scholar
  18. 18.
    Sundaram V, Helweg-Larsen K, Laursen B, Bjerregaard P. Physical violence, self rated health, and morbidity: is gender significant for victimisation? J Epidemiol Community Health. 2004;58(1):65–70.PubMedCrossRefGoogle Scholar
  19. 19.
    Grayson DA. Confounding confounding. Am J Epidemiol. 1987;126:546–53.PubMedGoogle Scholar
  20. 20.
    Feder GS, Hutson M, Ramsay J, Taket AR. Women exposed to intimate partner violence: expectations and experiences when they encounter health care professionals: a meta-analysis of qualitative studies. Arch Intern Med. 2006;166:22–37.PubMedCrossRefGoogle Scholar
  21. 21.
    Max W, Rice DP, Finkelstein E, Bardwell RA, Leadbetter S. The economic toll of intimate partner violence against women in the United States. Violence Vict. 2004;19(3):259–72.PubMedGoogle Scholar
  22. 22.
    Thompson RS, Bonomi AE, Anderson M, et al. Intimate partner violence prevalence, types and chronicity in adult women. Am J Prev Med. 2006;30(6):447–57.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Laura A. McCloskey
    • 1
  • Corrine M. Williams
    • 2
  • Erika Lichter
    • 3
    • 4
  • Megan Gerber
    • 5
  • Michael L. Ganz
    • 6
    • 7
  • Robert Sege
    • 8
  1. 1.Merrill Palmer Skillman InstituteWayne State UniversityDetroitUSA
  2. 2.Center for Disease ControlRockvilleUSA
  3. 3.Department of Public HealthPortlandUSA
  4. 4.University of Southern MainePortlandUSA
  5. 5.Harvard Vanguard, Harvard Medical SchoolBostonUSA
  6. 6.Abt AssociatesLexingtonUSA
  7. 7.Harvard University School of Public HealthBostonUSA
  8. 8.New England Medical CenterTufts University Medical SchoolBostonUSA

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