“Boiling water but there's no pop-off valve”: Health care professionals’ perceptions of the effects of COVID-19 on Intimate Partner Violence Open Access

Hendrix, Ellen (Spring 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/jq085m141?locale=en
Published

Abstract

Introduction: Anecdotal evidence suggests an increase in intimate partner violence (IPV) during the COVID-19 pandemic yet little is known about the impacts of movement-related restrictions on experiences of IPV; even less is known about health providers’ perceptions of these same issues. The purpose of this study was to understand the impacts of COVID-19 on IPV from the perspective of health care professionals (HCPs). 

Methods: From November 2020 to January 2021 semi-structured interviews were conducted with eight HCPs at a large public hospital in Atlanta, Georgia. Participants included emergency medicine physicians (n=4), trauma surgeons (n=3), and a social worker (n=1). A thematic analysis with both deductive and inductive codes was conducted to identify themes.

Results: Six themes emerged from the eight interviews with HCPs providing insight into their perceptions and observations of COVID-19 movement-related restrictions on IPV. These themes include: (1) COVID-19 movement-related restrictions likely exacerbated IPV; (2) IPV increased (spiked) two times during COVID-19; (3) HCPs encountered many barriers and few facilitators to IPV care provision during COVID-19; (4) IPV patients expressed fears in seeking care but did not delay treatment during the pandemic; (5) relative to the pre-pandemic period HCPs perceived no changes in IPV case presentation or severity; and (6) HCPs suggested specific internal and external improvements for IPV response. Navigating the safe discharge of patients was a primary barrier discussed by HCPs which they attributed to: a lack of community resources for people experiencing IPV; changing policies on testing requirements; fewer admissions into support facilities to observe social distancing; and the closing of a women’s shelter at the start of 2020.  

Conclusions: This study deepens the understanding of the impacts of COVID-19 movement-related restrictions on IPV. Findings along with suggestions from HCPs for prevention and response to IPV during pandemics can be used to inform future pandemic preparedness. 

Table of Contents

Chapter 1: Introduction 1

Problem Statement 3

Purpose Statement 4

Research Objective and Aims 4

Significance Statement 5

Definition of Terms 6

Chapter 2: Literature Review 7

Intimate Partner Violence 7

Consequences of IPV 8

IPV during emergencies or in emergency settings 9

IPV and natural disasters 9

IPV and humanitarian settings 10

IPV and pandemics 11

IPV during the COVID-19 pandemic 12

Media Reports 12

Rapid Data Reviews 13

Empirical Evidence 14

Reports of decreased IPV resource use 15

Pathways between COVID-19 and increased IPV 16

Health impacts of movement-related restrictions 17

Role of health care professionals 18

Conclusion and added value 19

Chapter 3: Methods 20

Design 20

Instrument 20

Participants 21

Data Collection 22

Data Analysis 22

Ethical Considerations 23

Chapter 4: Results 24

Participant Demographics 24

COVID-19 movement-related restrictions likely exacerbated IPV 25

IPV increased (spiked) two times during COVID-19 28

HCPs encountered many barriers and few facilitators in IPV care provision during COVID-19 30

IPV patients expressed fears in seeking care but did not delay treatment during the pandemic 33

Relative to pre-pandemic period, HCPs perceived no changes in IPV case presentation or severity 34

HCPs suggested specific internal and external improvements for IPV response 36

Chapter 5: Discussion 39

Limitations 44

Chapter 6: Conclusions and Recommendations 46

Conclusions 46

Concurrent response to IPV and COVID-19 46

Build IPV support into future pandemic preparedness 47

Integrating IPV into health care professionals’ education 48

Recommendations for future research 48

References 52

Appendix I: In-Depth Interview Guide 63

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