ABSTRACT
BACKGROUND: Intimate partner violence (IPV) is a prevalent yet underdiagnosed health issue, and primary care practitioners are in a unique front-line position to provide care and counsel for the victims. OBJECTIVE: To identify the signs and symptoms of women exposed to IPV who attended primary care, regardless motive of consultation. METHODS: Systematic review and meta-analysis on Cochrane, PubMed, Embase and CINAHL between 1946 and 2020. Eligible studies had to be original quantitative research, on women aged >15 years, attending primary care settings in Europe, North America and Australia and interviewed on their status as victims of IPV and on their signs and symptoms. RESULTS: Of 1791 articles identified, 57 were selected. Associations were found between IPV and signs and symptoms of depression [19 studies: overall odds ratio (OR) = 3.59, 95% confidence interval (CI; 2.7-4.7, I2 = 94.6%)], anxiety [9 studies: overall OR = 2.19, 95% CI (1.75-2.73, I2 = 84%)], gynaecological and/or sexually transmitted infections [6 studies: overall OR = 2.82, 95% CI (2.1-3.8, I2 = 41%)] and combination of somatic symptoms [5 studies: standard mean deviation = 0.795, 95% CI (0.62-0.97, I2 = 0%)]. CONCLUSIONS: Women exposed to IPV may present with clinical symptoms and signs other than bodily injury. Policy implications knowing these symptoms presented by women victims of IPV can help GPs identify and treat them. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018089857.
Subject(s)
Intimate Partner Violence , Sexually Transmitted Diseases , Anxiety , Europe , Female , Humans , Primary Health CareABSTRACT
Violence has a major impact on the health of victims and can be masked by various psychological and somatic pathologies. Systematic questioning by general practitioners gives women the opportunity to be finally heard and enables doctors to make the connection with the violence to which they are being subjected. Identifying this abuse is essential in order to be able to help and orient the women towards the appropriate support.
Subject(s)
Domestic Violence/prevention & control , Domestic Violence/psychology , General Practice , Physician's Role , Psychophysiologic Disorders/nursing , Somatoform Disorders/diagnosis , Somatoform Disorders/nursing , Spouse Abuse/prevention & control , Spouse Abuse/psychology , Adult , Aged , Female , France , Humans , Physician-Patient Relations , Pregnancy , Psychophysiologic Disorders/diagnosis , Psychophysiologic Disorders/psychology , Self Disclosure , Socioeconomic Factors , Somatoform Disorders/psychologyABSTRACT
INTRODUCTION: In France, more than 4 million people benefit from the universal complementary health insurance coverage (CMUc). Approved by many doctors, CMUc remains discussed by a part of the medical profession. What is the perception of general medical practice students regarding patients receiving CMUc and what are the determinants influencing it? METHODS: A cross-sectional study was carried out by providing final year interns in general medicine with a self-administered questionnaire. The primary assessment criterion was the perception of the interns regarding patients receiving CMUc, classified into three categories: positive, negative or neutral. After a description of the sample, statistical analysis included multivariate logistic polytomous regression models developed with the SAS 9.1 software. RESULTS: A total of 57.1% (200) of the third year interns of Île-de-France in 2009-2010 responded to the questionnaire. Forty-two percent of students had a "neutral" perception of the patients receiving CMUc, 41% a "positive" one and 17% a "negative" one. Influencing factors were: the perception of the first encounter, the gender of the intern, the type of practice that he intended to take up and the experience he had of patients receiving CMUc. In multivariate analysis, a positive impression of the first encounter significantly increased the probability of having a positive future perception compared to a negative impression of the first encounter (OR=16,19 [2,37-110,48]). DISCUSSION: To improve these perceptions, the main proposals are increased contacts with underprivileged populations and the close supervision of the students by their course tutors.
