Marshall Rory A, Merritt Nicole, Stranges Tori N, Bartlett Stephen, Sawyer Simon, van Donkelaar Paul
School of Health and Exercise Sciences, Faculty of Social Development, University of British Columbia Okanagan, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
British Columbia Emergency Health Services, 101-1515 Keehn Road, Kelowna, BC, V1X 5T3, Canada.
BMC Womens Health. 2025 May 26;25(1):254. doi: 10.1186/s12905-025-03753-9.
Intimate partner violence (IPV) persists as a severe and prevalent criminal, social, and health issue, most commonly affecting women. Survivors of IPV frequently engage with the healthcare system to access treatment, support, and resources. Paramedics commonly encounter, either knowingly or unknowingly, patients experiencing IPV. There is little empirical research on how paramedics manage cases involving IPV.
To examine how the perspectives and experiences of survivors of IPV who have been attended to by paramedics can inform our understanding of paramedic services.
Using an interpretive description qualitative approach in the context of paramedicine, self-identified women (18+ years) who reported a history of IPV and being attended to by paramedics for IPV-caused reasons participated in semi-structured interviews. Interviews were transcribed verbatim and de-identified. De-identified transcripts were inductively analyzed (NVivo) for common patterns.
N = 9 survivors participated in interviews. Participants experienced cyclic and escalating physical, sexual, psychological, and coercive control forms of IPV. Participants primarily reported accessing paramedic services following instances of severe IPV and reported receiving minimal treatment and support. Challenges included bias and discrimination, poor individual paramedic conduct, undereducated and undertrained paramedics, insufficient infrastructure, inadequate transitions into healthcare and community services, perpetrator dynamics, and survivor dynamics. Corresponding solutions were safe and equitable paramedic behaviour, respectful conduct, mandatory education and training, develop functional infrastructure, develop functional transitions, and utilize techniques to engage with perpetrators and survivors.
Personal, situational, practitioner, paramedic service, and broad systemic infrastructure challenges cause survivors of IPV to be underserviced by paramedic services. Inadequate intervention efforts may be harmful or fatal for survivors. Survivor-derived solutions may guide paramedic service improvements. With improved service delivery, paramedics could evolve into reliable and useful resources for survivors of IPV.
亲密伴侣暴力（IPV）仍然是一个严重且普遍存在的犯罪、社会和健康问题，最常影响女性。IPV幸存者经常与医疗保健系统接触以获得治疗、支持和资源。护理人员经常有意或无意地遇到遭受IPV的患者。关于护理人员如何处理涉及IPV的病例，实证研究很少。
研究接受过护理人员照料的IPV幸存者的观点和经历如何增进我们对护理服务的理解。
在护理医学背景下采用解释性描述定性方法，自我认定有IPV病史且因IPV相关原因接受过护理人员照料的18岁及以上女性参与了半结构化访谈。访谈逐字记录并进行去识别处理。对去识别后的转录本进行归纳分析（NVivo）以找出常见模式。
9名幸存者参与了访谈。参与者经历了IPV的周期性和升级性的身体、性、心理和强制控制形式。参与者主要报告在严重IPV事件后寻求护理服务，并表示得到的治疗和支持很少。挑战包括偏见和歧视、个别护理人员行为不当、教育程度低和培训不足的护理人员、基础设施不足、向医疗保健和社区服务的过渡不充分、施暴者动态以及幸存者动态。相应的解决方案是安全公平的护理人员行为、尊重行为、强制性教育和培训、建立功能性基础设施、建立功能性过渡以及运用与施暴者和幸存者接触的技巧。
个人、情境、从业者、护理服务和广泛的系统基础设施挑战导致IPV幸存者在护理服务中未得到充分服务。干预措施不足可能对幸存者有害或致命。源自幸存者的解决方案可能会指导护理服务的改进。随着服务提供的改善，护理人员可以发展成为IPV幸存者可靠且有用的资源。
