Annotated Bibliography

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You are required to complete an annotated bibliography comprised studies on your chosen FOP (Field of Practice). The FOP is 'improve the service for the mental health of women who have been exposed to family violence in Australia'

The research papers are to relate to best practice i.e. address and provide evidence that tells us how to improve service, practice or outcomes in your chosen FOP. The papers you assess must have a sample and have actually gathered and analysed data. This means no systematic literature reviews.

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454722 urnal of Interpersonal ViolenceHegarty et al. © The Author(s) 2013 JIV28210.1177/0886260512454722Jo Reprints and permission: http://www. sagepub.com/journalsPermissions.nav Article Journal of Interpersonal Violence 28(2) 273­–294 © The Author(s) 2013 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0886260512454722 http://jiv.sagepub.com Effect of Type and Severity of Intimate Partner Violence on Women’s Health and Service Use: Findings From a Primary Care Trial of Women Afraid of Their Partners Kelsey L. Hegarty, MBBS, FRACGP, DRANZCOG, PhD,1 Lorna J. O’Doherty, BA, MBS, PhD,1 Patty Chondros, BSc(Hons), GradDip Epidemiology & Biostats, MSc(Statistics), PhD,1 Jodie Valpied, BA/ BTeach, PGDipPsych, COGE, MEd,1 Angela J. Taft, BA, DipEd, MPH, PhD,2 Jill Astbury, BA, MEd, PhD,3 Stephanie J. Brown, BA(Hons), PhD,4 Lisa Gold, PhD,5 Ann Taket, BA, MSc, PhD,5 Gene S. Feder, BSc, MD, FRCGP, DRCOG,6 and Jane M. Gunn, MBBS, FRACGP, DRANZCOG, PhD1 Abstract Intimate partner violence (IPV) has major affects on women’s wellbeing. There has been limited investigation of the association between type and severity of IPV and health outcomes. This article describes socio-demographic characteristics, experiences of abuse, health, safety, and use of services in women enrolled in the Women’s Evaluation of Abuse and Violence Care 1 The University of Melbourne, Melbourne, Australia La Trobe University, Melbourne, Australia 3 Monash University, Melbourne, Australia 4 Murdoch Childrens Research Institute, Melbourne, Australia 5 Deakin University, Burwood, Australia 6 University of Bristol, Bristol, UK 2 Corresponding Author: Kelsey L. Hegarty, MBBS, FRACGP, DRANZCOG, PhD, Associate Professor, General Practice, University of Melbourne, 200 Berkeley Street, Melbourne,VIC 3053, Australia Email: k.hegarty@unimelb.edu.au 274 Journal of Interpersonal Violence 28(2) (WEAVE) project. We explored associations between type and severity of abuse and women’s health, quality of life, and help seeking. Women (aged 16– 50 years) attending 52 Australian general practices, reporting fear of partners in last 12 months were mailed a survey between June 2008 and May 2010. Response rate was 70.5% (272/386). In the last 12 months, one third (33.0%) experienced Severe Combined Abuse, 26.2% Physical and Emotional Abuse, 26.6% Emotional Abuse and/or Harassment only, 2.7% Physical Abuse only and 12.4% scored negative on the Composite Abuse Scale. A total of 31.6% of participants reported poor or fair health and 67.9% poor social support. In the last year, one third had seen a psychologist (36.6%) or had 5 or more general practitioner visits (34.3%); 14.7% contacted IPV services; and 24.4% had made a safety plan. Compared to other abuse groups, women with Severe Combined Abuse had poor quality of life and mental health, despite using more medications, counseling, and IPV services and were more likely to have days out of role because of emotional issues. In summary, women who were fearful of partners in the last year, have poor mental health and quality of life, attend health care services frequently, and domestic violence services infrequently. Those women experiencing severe combined physical, emotional, and sexual abuse have poorer quality of life and mental health than women experiencing other abuse types. Health practitioners should take a history of type and severity of abuse for women with mental health issues to assist access to appropriate specialist support. Keywords domestic violence, anything related to domestic violence, assessment, intervention/treatment Intimate partner violence (IPV) is common in the community (Abramsky et al., 2011; Australian Bureau of Statistics, 2005; Garcia-Moreno, Jansen, Ellsberg, Heise, & Watts, 2006) and clinical populations, particularly in primary care (Feder et al., 2009). It contributes to substantial physical and mental health burden among women in developing and developed parts of the world (Campbell, 2002; Ellsberg, Jansen, Heise, Watts, & Garcia-Moreno, 2008). In Australia, IPV is the leading cause of morbidity and mortality for women of child bearing age (Vos et al., 2006). Abused women use medical services more frequently because of increased rates of mental health issues (depression, anxiety, suicide, somatization, posttraumatic stress disorder, substance Hegarty et al. 275 abuse; Golding, 1999; Rees et al., 2011) and physical health issues (chronic somatic complaints, reproductive problems and injuries; Campbell, 2002). Despite the pervasive effects of IPV on societies, there are few trials of interventions for IPV in health care settings. Furthermore, there is a paucity of quantitative data on how different types and severity of abuse relate to women’s health, quality of life, and service use, with most data coming from the specialist service sector (e.g., Bonomi, Holt, Martin, & Thompson, 2006; Feder et al., 2009; Straus et al., 2009; Wuest et al., 2010). Gathering this data is hampered by most measures of IPV not characterizing type and severity of abuse (Hegarty, 2006). In studies that have made these distinctions, higher severity of abuse has been associated with lower mental and physical health status, quality of life, and higher levels of depression, posttraumatic stress disorder and chronic pain (Dutton, Kaltman, Goodman, Weinfurt, & Vankos, 2005; Straus et al., 2009; Wuest et al., 2010). The nature of these associations has differed according to the type of abuse experienced. For example, Wuest et al. found a relationship between chronic pain and severity of abuse, but only for psychological abuse. Dutton et al. found that women who had experienced more severe psychological and physical abuse were at greater risk of revictimization, but only if they had not also experienced severe sexual violence from their partners. Other studies have found that particular forms of abuse, such as harassment, put women at greater risk of revictimization, regardless of abuse severity (e.g., Cole, Logan, & Shannon, 2008). These studies show that the complex relationship between type and severity of abuse need to be taken into account when measuring IPV and related outcomes. Many health organizations (e.g., American Medical Association, 2008; Joint Commission for the Accreditation of Healthcare Organizations [JCAHO], 2011) recommend screening for IPV in health care settings, although the evidence on whether screening does more good than harm is limited (Feder et al., 2009) with a recent Canadian trial showing no beneficial health outcomes from screening alone (MacMillan et al., 2009). The primary care setting has potential to facilitate early intervention given the high level of contact women have with family practice (Feder et al., 2011). The Women’s Evaluation of Abuse and Violence Care (WEAVE) project is the first family practice based trial testing the effect of screening plus intervention for IPV on women’s health and wellbeing (Hegarty et al., 2010). The trial protocol (Hegarty et al., 2010), intervention (Hegarty, O’Doherty, Gunn, Pierce, & Taft, 2008), and screening stage (Hegarty, O’Doherty, Astbury, & Gunn, 2012) have been described in detail elsewhere. In this article, we report an analysis of associations of type and severity of IPV with trial participants’ health and wellbeing, safety planning, and use of support and clinical services. This fills a gap in 276 Journal of Interpersonal Violence 28(2) the literature examining associations specifically of type and severity of IPV with health outcomes. Method Between June 2008 and May 2010, women aged 16–50 years attending participating urban and rural general practitioners (GPs) in the previous 12 months were sent a postal screening survey. Women were excluded if the GP anticipated they may encounter difficulties in providing informed consent or understanding the surveys. The survey contained a series of items about lifestyle issues (Goodyear-Smith, Arroll, & Coupe, 2009), including an item about fear of partner to screen for IPV (Hegarty, Bush, & Sheehan, 2005). Women who indicated fear of a partner and supplied contact details were phoned by a research assistant and invited to participate in the trial. Additional exclusions were undertaken at this point if women had misinterpreted the fear item or been fearful more than 12 months ago, had moved, or had poor English language skills. Women willing to be involved were sent a baseline survey, an information leaflet and a resource services card to their nominated “safe” address. The baseline survey was adapted from surveys used in the DIAMOND study (Gunn et al., 2008). The survey included socio-demographic items, childhood abuse (Child Maltreatment History Self-Report; MacMillan et al., 1997), quality of life (WHOQOL-Bref; Skevington, Lotfy, & O’Connell, 2004), physical and mental health status (Short-Form 12; SF-12; Ware, Kosinski, & Keller, 1996), safety (Safety-Promoting Behaviour Checklist; SPBC; McFarlane, Parker, Soeken, Silva, & Reel, 1998), anxiety and depression (Hospital Anxiety and Depression Scale; HADS; Zigmond & Snaith, 1983), posttraumatic stress disorder (Short Screening Scale for DSM-IV PTSD; Breslau, Peterson, Kessler, & Schultz, 1999), days out-of-role; alcohol use (Alcohol Use Disorders Identification Test; AUDIT; Saunders, Aasland, Babor, de la Fuente, & Grant, 1993), smoking, and medication use. IPV was measured using the Composite Abuse Scale (CAS; Hegarty et al., 2005), which categorizes respondents according to four different types of abuse experienced in the last 12 months: (i) Severe Combined Abuse, (ii) Physical and Emotional Abuse, (iii) Physical Abuse only, and (iv) Emotional Abuse and/ or Harassment only. Women who did not meet the criteria for any of the abuse types on the CAS (e.g., because the abuse was longer than 12 months ago) were classified as fearful in the past 12 months but negative for IPV. The survey also measured GPs’ inquiry about safety of women and their children, service utilization, and visits to health care providers. Hegarty et al. 277 Once baseline surveys were returned, women were formally enrolled in the trial and GPs (and women) were randomly allocated to intervention or comparison groups. This article focuses on data emerging from the baseline assessment only. The study was granted ethics approval by the Human Research Ethics Committee of The University of Melbourne and is undertaken in accordance with CONSORT guidelines (Schulz, Altman, & Moher, 2010). Data were summarized using frequencies and percentages for categorical data, and means and standard deviations for continuous data. Data met all assumptions for statistical tests performed. Marginal logistic regression was used to compare patient characteristics between the fearful women who agreed to enrol in the trial and those who did not. Women’s experiences of quality of life, health status, lifestyle, safety and help seeking behaviors and health care utilization were compared across the four abuse categories (namely, fearful but CAS-negative, Severe Combined Abuse, Physical and Emotional Abuse, and Emotional Abuse, and/or Harassment only). Women in the Physical Abuse only group were excluded from the analysis because there were only five women. The association between each of the outcome variables and type of abuse was tested using marginal linear and logistic regression models for continuous and binary outcomes, respectively. The marginal models were fitted using generalized estimating equations with information sandwich estimates of the standard errors to allow for the correlation between responses of the women that attend the same general practice. Results were presented as mean score differences (95% confidence intervals, CI) for the continuous outcomes for each abuse category (Severe Combined Abuse, Physical and Emotional Abuse, and Emotional Abuse and/ or Harassment only) compared to the group where women were fearful but CAS negative, which was chosen as the reference category for the analysis. Results were presented as odds ratios (OR) with 95% CIs for binary outcomes for each of the three CAS positive groupings compared to the reference group. Overall p-values that summarize the strength of the association between each outcome and abuse type were also reported. Estimates were also adjusted for age, marital status, income, and education based on a priori hypotheses of an independent association with abuse derived from the literature (Hegarty, Gunn, Chondros, & Small, 2004; Hegarty, Gunn, Chondros, & Taft, 2008). Data were analyzed using STATA, version 11.0 (StataCorp, 2009). Results Figure 1 shows the flow of patient participants up to enrolment in the baseline phase of the trial. Across 55 practices initially recruited into the study, 278 Journal of Interpersonal Violence 28(2) 5,742/19,879 (28.9%) women returned a screening survey; 731/5,742 (12.7%) of them reported being afraid of a partner or ex-partner in the previous 12 months and 477/731 (65.3%) supplied contact details. Furthermore, 91 women were established as ineligible once they were contacted. Ultimately, 272/386 (70.5%) women from 52 practices completed the baseline assessment and enrolled in the trial. Three GPs were excluded from the analysis because none of their screened patients were eligible for participation. There was no difference between women who enrolled in the trial and fearful women who did not enrol, by age, employment, relationship status, or birthplace (see Table 1). However, trial enrolees were more often separated or divorced, had less school education, and were more likely to have English as their first language compared to fearful non-enrolees. Trial enrolees also experienced more fear of partner than fearful non-enrolees (52.2% versus 38.1% fearful some, most or all of the time). Figure 2 shows the proportions of trial enrolees at baseline (N = 272) who experienced each type of abuse in the last 12 months. Severe Combined Abuse was the most common type of abuse experienced (33.0%), followed closely by Physical and Emotional Abuse (26.2%), and Emotional Abuse and/or Harassment only (26.6%); whereas only five participants (2.7%) had experienced Physical Abuse only. More than half (64.0%) of trial participants had experienced physical and/or sexual abuse as a child. Participants had fair or poor health (31.6%) and poor social support (67.9%). They had high levels of mental ill health, with one third of the women being on antidepressants (33.2%) or painkillers (32.1%) and were frequent users of health care services. However, in the past 12 months, only 11.2% had seen a social worker, 14.7% had sought help from a domestic violence service, 20.4% had contact with police, and 25.4% had contacted legal services. Around one quarter (24.4%) had ever made a safety plan. Table 2 shows that trial enrolees had lower scores on all dimensions of quality of life (WHOQOL-Bref) and mental health (SF-12) compared to the Australian population (Australian Bureau of Statistics, 1997; Hawthorne, Herrman, & Murphy, 2006). Overall, women experiencing Severe Combined Abuse reported lower quality of life on the physical, psychological, and environmental dimensions of the WHOQOL-Bref compared to all other abuse categories. Although women experiencing some form of abuse (Severe Combined Abuse, Physical and Emotional Abuse, or Emotional Abuse and/or Harassment only) reported lower quality of life on the social dimension of the WHOQOL-Bref and lower mean mental health scores on SF-12 compared to the women who reported being fearful but CAS negative. 279 Hegarty et al. Eligible patients sent screening survey (N=19879 at 55 practices) Did not return survey (N=14137) Returned survey (N=5742; 28.9%) Screened positive for fear of partner (N=731; 12.7%) Did not screen positive for fear of partner (N=5011; 87.3%) Did not supply contact details (N=254)a 2 GPs excluded: No eligible women identified Supplied contact details (N= 477 at 53 practices; 65.3%) Declined: N=39a Ineligible: N=91a Could not be contacted: N=19a Missed screening cut-off date: N=1a Did not return baseline survey: N=55a 1 GP excluded: No eligible women identified. Returned baseline and enrolled in trial (N=272 at 52 practices) Figure 1. Flowchart of patient participation in the WEAVE trial before randomization of practices Note. aPatients who screened positive for fear of partner but did not enrol in the trial are referred to as fearful non-enrolees throughout the article (N = 459). Table 3 shows that women in the Severe Combined Abuse group were also more likely than the other abuse groups to report PTSD, anxiety symptoms, sedative, analgesic, and antidepressant use, and to experience days out-ofhome duties because of emotional issues. Those experiencing Severe Combined Abuse or Physical and Emotional Abuse were also more likely 280 Journal of Interpersonal Violence 28(2) Table 1. Socio-Demographic Characteristics of Trial Enrolees (N = 272) and NonEnrolees (N = 459)a Age
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