Health & Healthcare for Women Affected by Domestic Violence: Stories of Disruption, Fragmentation & Reconstruction

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Wallis, Marianne

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Rowe, Jennifer

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Date
2008
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Abstract

Domestic violence is a major public health issue that influences all aspects of affected women’s lives and has far reaching impacts across all levels of society (Fraser, 2003). The impact of domestic violence on women’s health is said to be devastating and is believed to result in poor general, reproductive and psychological health (Parker & Lee, 2002). There is also evidence that the negative impact on women’s health is long term and continues even after the violence has ended.

Women who are subjected to domestic violence seek help from a wide range of professionals within health and social care sectors, and evidence suggests that their experiences tend to be negative.

This study explored the health issues and healthcare encounters of women who lived with domestic violence. The purpose of the research was to seek information about the healthcare of women who are subjected to or who have been subjected to domestic violence perpetrated by intimate male partners, and to use this information to inform healthcare practitioners. A postmodern and feminist lens was applied to the study. The framework for the study was interpretive interactionism (Denzin, 2001). Data were generated from in-depth interviews undertaken with women who had lived with domestic violence and with nurses employed in Emergency Department and Community Health settings often accessed by women affected by domestic violence. Documents tracing central policy development in relation to health and human services’ responses to domestic violence were also examined. Narrative analytic techniques were employed to interpret the storied accounts told by women affected by violence and nurses.

Findings from the study revealed much information about health and healthcare as it is experienced by women affected by domestic violence and by health professionals (in this case nurses) who care for them. Healthcare responses to women affected by domestic violence are currently enacted under policy that de-genders this form of violence and fragments responses to women’s needs. It is clear that biomedical discourse is the dominant lens informing health service and health professionals’ practice. Within healthcare settings trajectories for women’s care and treatment are apparent that are outcome focussed and embrace therapeutic values of diagnosis, treatment and cure. However, this response fails to acknowledge the complexity and needs of women affected by domestic violence. Further the findings demonstrate that the approach also has negative impacts on the health and wellbeing of women who present for healthcare.

A new lens is provided here, from which to view women’s health issues and through which to understand the impact of current healthcare and also through which alternative trajectories of care may be proposed. Biographical disruption (Bury 1982) is a framework which highlights how, as a result of living with domestic violence, women experience significant fracturing of their sense of self and attempt to traverse a liminal space in which their personal biographies and identities are shaped not only by their experiences of living in violent relationships and their emerging health issues, but also by the healthcare service that responds to their issues. There are critical points at which health professionals can support women, particularly on presentation.

This study has added to the growing body of knowledge that seeks to inform healthcare services and practitioners who practice within these services about the needs of women affected by domestic violence. The notion of health as a ‘given’ has been challenged and health as a process of disruption, re-evaluation and re-construction of sense of self has been conceptualised.

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Thesis (PhD Doctorate)

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Doctor of Philosophy (PhD)

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Faculty of Nursing and Midwifery

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The author owns the copyright in this thesis, unless stated otherwise.

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Subject

domestic violence

marital violence

spousal abuse

family violence

women's health

women's healthcare

health

healthcare

sense of self

human services

responses to domestic violence

health professionals

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