Department of Arts and Sciences, University of Houston-Victoria, Victoria, TX, USA.
Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
Health Soc Care Community. 2021 May;29(3):612-630. doi: 10.1111/hsc.13282. Epub 2021 Jan 13.
Domestic violence victims are in frequent contact with the healthcare service yet rarely disclose. Therefore, it is critical to understand victims' experiences and perceptions regarding disclosure in healthcare settings. The goal of this review is to provide an updated synthesis of qualitative research identifying barriers and facilitators, advice, and positive and negative outcomes of adult victims' disclosure of domestic violence to healthcare professionals (HCPs). A systematic search of PsychINFO, CINAHL and Web of Science was conducted in January 2018. Thirty-four eligible studies were identified, including 783 domestic violence victims (781 females). Formal quality assessment indicated variable study quality. Barriers of disclosure included negative HCPs attitudes, victims' perceptions of safety and concerns about the consequences of disclosing. Facilitators of disclosing included a positive relationship with the HCP, HCPs directly asking victims about abuse, and HCPs ensuring that the environment is safe and disclosure is confidential. Victims advised increased awareness of HCPs reactions to disclosure and avoiding mirroring their perpetrators minimization. HCPs were encouraged to engage in direct questioning and maintain a supportive and secure environment. Positive and negative outcomes of abuse were identified, such as being able to leave the abuser or, on the other hand, the victims' situation not changing. Our results indicate that barriers for disclosure of domestic violence in healthcare settings persist despite the widespread implementation of policies and guidelines to counter them. Based on these findings, we provide recommendations for clinical practice and future research to help improve disclosure in healthcare settings.
家庭暴力受害者经常与医疗保健服务部门接触，但很少披露其遭受的暴力行为。因此，了解受害者在医疗保健环境中披露相关信息的经历和看法至关重要。本综述的目的是提供最新的定性研究综合报告，以确定成人受害者向医疗保健专业人员（HCP）披露家庭暴力的障碍和促进因素、建议以及积极和消极结果。2018 年 1 月，对 PsychINFO、CINAHL 和 Web of Science 进行了系统检索。确定了 34 项符合条件的研究，其中包括 783 名家庭暴力受害者（781 名女性）。正式的质量评估表明研究质量存在差异。披露障碍包括 HCP 的负面态度、受害者对安全的看法以及对披露后果的担忧。披露的促进因素包括与 HCP 的良好关系、HCP 直接询问受害者有关虐待的问题，以及 HCP 确保环境安全并对披露内容保密。受害者建议提高 HCP 对披露的反应意识，避免模仿施虐者的轻视态度。鼓励 HCP 进行直接提问，并保持支持和安全的环境。确定了虐待行为的积极和消极后果，例如能够离开施虐者，或者受害者的情况没有改变。我们的研究结果表明，尽管已经广泛实施了相关政策和指南来解决这些问题，但医疗保健环境中披露家庭暴力的障碍仍然存在。基于这些发现，我们为临床实践和未来的研究提供了建议，以帮助改善医疗保健环境中的披露情况。
