ABSTRACT
AIMS: The aim was to examine and describe women's emergency department visits and care-seeking experiences, including recognition, evaluation and communication of symptoms, injuries and health risks after non-fatal intimate partner strangulation. DESIGN: Using a diagnostic process framework, this mixed-methods study explores concordance and discordance of interview and medical records data to highlight opportunities for clinical diagnostic improvement. METHODS: In-depth, semi-structured interviews with women after an emergency department visit for non-fatal intimate partner strangulation, concurrent with medical records reviews, were conducted between March 2018 and January 2019. A constant comparative approach was used to analyse interview and medical record data using an a priori codebook designed based on the National Academies of Science, Engineering and Medicine's conceptual model of the diagnostic process and prior intimate partner violence research. RESULTS: Interviews reflected participants did not have a sense of long-term health risks from their strangulation beyond addressing emotional trauma. Women noted that forensic and emergency nursing support was treatment in and of itself that allowed them to be heard and validated. Medical record clinical impressions and final diagnoses included domestic violence, domestic abuse or sexual assault, but not specifically strangulation. CONCLUSION: This study contributes to the growing literature regarding strangulation diagnosis and care. Our findings provide new details of women's emergency department care-seeking experiences which, whilst overall aligned with medical records documentation, were not reflected in final diagnostic impressions nor in patient recollection of long-term health risks. IMPACT: Nurses are strongly positioned as clinical practice leaders and policy advocates to improve collective responses to this dangerous violence mechanism. Actions such as improving patient education, referral and follow-up options to better communication and address long-term strangulation risk are one example. Further research on non-fatal intimate partner strangulation and care-seeking is warranted to expand this knowledge, particularly in longitudinal cohorts and varied geographical areas.
Subject(s)
Domestic Violence , Intimate Partner Violence , Female , Humans , Intimate Partner Violence/psychology , Sexual Partners , Emergency Service, Hospital , Patient Acceptance of Health CareABSTRACT
Recalibration of affordance perception in response to changing motor abilities can only occur if observers detect appropriate perceptual information. Recent work suggests that although many affordances can be recalibrated without practicing the specific action to gather outcome feedback-information about whether the attempted action succeeded or failed-calibration of other affordances might depend on outcome feedback (Franchak, Attent Percept Psychophys 79:1816-1829, 2017). However, past work could not rule out the possibility that practicing the action produced perceptual-motor feedback besides outcome feedback that facilitated recalibration. The results of two experiments support the hypothesis that recalibration in a doorway squeezing task depends on outcome feedback as opposed to perceptual-motor feedback. After putting on a backpack that changed participants' doorway squeezing ability, affordance judgments were uncalibrated and remained so even after making repeated judgments. However, after practicing the action, which produced outcome feedback, judgments rapidly calibrated. Moreover, the order of feedback information directly impacted participants' judgments: Participants did not recalibrate if they received only success experience or only failure experience. Recalibration only occurred after participants received both types of feedback experiences, suggesting that outcome feedback is necessary for recalibration in the doorway squeezing task. More generally, the results of the current study support a key tenet of ecological psychology-that affordance perception depends on action-specific information about body-environment relations.
