Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2024 Aug 23;19(8):e0306599. doi: 10.1371/journal.pone.0306599. eCollection 2024.
Intimate partner violence (IPV) is a global public health crisis, with physical violence leaving IPV survivors at high risk of brain injury (BI). Both BI and IPV have significant physical, psychological, cognitive, and social impacts, including a high risk of mental health concerns, yet there is limited exploration of IPV survivors' experiences with BI and mental health. This study aimed to explore the BI- and mental health-related needs and experiences of IPV survivors from the perspectives of survivors and service providers with the objective of developing knowledge translation materials to raise awareness and support survivors and service providers in addressing these concerns.
This qualitative interpretive description study involved 19 semi-structured interviews and two focus group discussions (2-3 participants each) with 24 participants including IPV survivors experiencing BI and mental health concerns as well as IPV, mental health, and BI service providers between October 2020 and February 2021. Three screening questions were used to identify probable BI among survivors. Participants across groups were an average of 48.5±12.7 years old and were predominantly cisgender women (96%), of European origin (75%), with a university degree (71%). Interviews were recorded, transcribed, and thematically analyzed.
Across interviews, participants spoke about IPV, BI, and mental health as being complex and interrelated experiences that have impacts across the survivor's life and extend well beyond the abusive relationship. Because of the underrecognized nature of BI in IPV, finding and accessing care requires persistence that survivors spoke of as being like "a full-time job." The benefit of making meaningful connections, particularly with other survivors, was highlighted.
Recognition of BI as a contributing factor shaping the lived experience of IPV survivors; acknowledgement that the impacts of IPV, BI, and mental health are far reaching and long lasting; and reducing barriers to finding and accessing appropriate care are critical to better supporting IPV survivors with BI and mental health concerns. Clinicians should consider BI and its lingering impacts among the IPV survivors with whom they work. Health and social policy that supports integration of care and the reduction of unnecessary barriers should be a priority.
亲密伴侣暴力（IPV）是全球公共健康危机，身体暴力使 IPV 幸存者面临高风险的脑损伤（BI）。BI 和 IPV 都对身体、心理、认知和社会产生重大影响，包括心理健康问题的高风险，但对 IPV 幸存者的 BI 和心理健康体验的探索有限。本研究旨在从幸存者和服务提供者的角度探讨 BI 和心理健康相关需求和体验，目的是开发知识转化材料，以提高认识并支持幸存者和服务提供者解决这些问题。
本定性解释性描述研究涉及 19 名参与者的 24 名半结构式访谈和 2 个焦点小组讨论（每组 2-3 名参与者），包括经历 BI 和心理健康问题的 IPV 幸存者以及 IPV、心理健康和 BI 服务提供者，时间为 2020 年 10 月至 2021 年 2 月。使用三个筛选问题来确定幸存者中可能存在的 BI。参与者的平均年龄为 48.5±12.7 岁，大多数为跨性别女性（96%），欧洲血统（75%），拥有大学学历（71%）。访谈进行了录音、转录和主题分析。
在整个访谈过程中，参与者谈到 IPV、BI 和心理健康是复杂且相互关联的体验，对幸存者的生活产生影响，并远远超出了虐待关系。由于 BI 在 IPV 中的认知不足，寻找和获得护理需要坚持，幸存者将其比作“全职工作”。建立有意义的联系，特别是与其他幸存者的联系，这一点非常重要。
认识到 BI 是塑造 IPV 幸存者生活体验的一个因素；承认 IPV、BI 和心理健康的影响广泛而持久；并减少寻找和获得适当护理的障碍，对于更好地支持有 BI 和心理健康问题的 IPV 幸存者至关重要。临床医生应考虑 BI 及其对他们所服务的 IPV 幸存者的挥之不去的影响。支持护理整合和减少不必要障碍的卫生和社会政策应成为优先事项。
