Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada.
Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada; Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada; KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario.
Arch Phys Med Rehabil. 2022 Jul;103(7):1466-1476. doi: 10.1016/j.apmr.2021.12.012. Epub 2022 Jan 7.
Intimate partner violence (IPV) affects 1 in 3 women and has intensified during the COVID-19 pandemic. Although most injuries are to the head, face, and neck, leaving survivors vulnerable to sustaining traumatic brain injury (TBI), the intersection of IPV and TBI remains largely unrecognized. This article reports on COVID-19-related effects, barriers, needs, and priorities to health care and support services for women survivors of IPV-TBI. Using a participatory research model, we engaged 30 stakeholders in virtual meetings drawn from an IPV-TBI Knowledge to Practice Network in two virtual meetings. Stakeholders included women survivors, service providers, researchers, and decision makers across the IPV, TBI, and healthcare sectors. Data were gathered through small group breakout sessions facilitated by the research team using semistructured discussion guides. Sessions were recorded, transcribed verbatim, and analyzed using thematic analysis techniques. Stakeholders were given the opportunity to contribute to the analysis and knowledge transfer through member checking activities. Ethics approval was obtained through the University of Toronto. Stakeholders shared that COVID-19 has increased rates and severity of IPV and barriers to services and help-seeking. These effects have been exacerbated by infrastructure difficulties in rural and remote areas, including limited access to services. They noted the need to carefully consider implications of virtual care such as safety, privacy, and usability. Requests from survivors for peer support have increased significantly, indicating a need for more formalized and better-supported peer roles. Stakeholders further noted that an overwhelming lack of awareness of the intersection of IPV-TBI continues. Increasing education and awareness among health care and IPV service providers, survivors, and the public remains a priority. The COVID-19 pandemic has intensified IPV-TBI, increased challenges for women survivors, and accentuated the continued lack of IPV-TBI awareness. Key recommendations for health care and rehabilitation to address this priority are discussed.
亲密伴侣暴力 (IPV) 影响了三分之一的女性，并且在 COVID-19 大流行期间有所加剧。尽管大多数伤害是头部、面部和颈部，但使幸存者容易遭受创伤性脑损伤 (TBI)，但 IPV 和 TBI 的交叉仍然很大程度上未被认识。本文报告了与 COVID-19 相关的影响、障碍、对 IPV-TBI 女性幸存者的医疗保健和支持服务的需求和优先事项。使用参与式研究模型，我们在两次虚拟会议中邀请了来自 IPV-TBI 知识转化实践网络的 30 名利益相关者参加虚拟会议。利益相关者包括来自 IPV、TBI 和医疗保健部门的女性幸存者、服务提供商、研究人员和决策者。通过研究团队使用半结构化讨论指南进行的小组分组会议收集数据。会议记录、逐字转录，并使用主题分析技术进行分析。利益相关者有机会通过成员核对活动为分析和知识转移做出贡献。通过多伦多大学获得了伦理批准。利益相关者表示，COVID-19 增加了 IPV 的发生率和严重程度，以及服务和寻求帮助的障碍。农村和偏远地区基础设施困难加剧了这些影响，包括服务获取有限。他们指出需要仔细考虑虚拟护理的影响，例如安全性、隐私和可用性。幸存者对同伴支持的需求显著增加，表明需要更正式和更好支持的同伴角色。利益相关者还指出，对 IPV-TBI 交叉的认识仍然严重不足。增加医疗保健和 IPV 服务提供者、幸存者和公众对这一交叉的认识仍然是一个优先事项。COVID-19 大流行加剧了 IPV-TBI，增加了女性幸存者的挑战，并突出了持续缺乏对 IPV-TBI 的认识。讨论了针对这一优先事项的医疗保健和康复的关键建议。
