Coping with intimate partner violence: Qualitative findings from the study of dynamics of husband to wife abuse.

INTRODUCTION: Coping can be defined as an individual's efforts to manage a problem. In Intimate Partner Violence (IPV), coping depends heavily on relationship context, circumstances, and resource availability. The range of coping strategies utilized by women experiencing violence are not fully understood. METHOD: Two hundred female patients who screened positive for verbal or physical abuse were recruited from 6 primary care clinics in San Antonio. Subjects were instructed to complete a baseline survey, which included the COPE scale, as well as daily telephone reports, weekly contact with research staff, and an end-of-study survey. A total of 42 women completed an in-depth qualitative interview at the end of 3 months. RESULTS: Using a template approach to qualitative analysis, interview transcripts were analyzed and coded. "Coping" as a theme emerged independently and was categorized into 14 subcategories, according to the COPE scale; the most commonly endorsed themes from interviews were "avoidance" and "active coping." Previously undescribed methods of coping with IPV were also discovered using this approach, including "preventing escalation" and "ignoring." DISCUSSION: In a qualitative study of women living with IPV, coping emerged as an independent theme. We found that the women used methods not listed on the COPE standardized scale at least as often as more traditional categories. It is important for family medicine clinicians to be aware of the wide variety of coping mechanisms to best address safety planning.

Becoming better health care providers: outcomes of a primary care service-learning project in medical school.

Medical educators have begun to embrace service-learning as a method for teaching medical students to be more socially responsible, patient-oriented practitioners. However, research documenting the learning outcomes of service-learning in medical education is limited. In this paper, written documents generated through evaluation of a mandatory, structured community service-learning experience were analyzed qualitatively to discover the diverse learning outcomes among 24 students who participated in the experience. Preliminary findings indicate that students developed skills and attitudes directly related to competencies of concern in most U.S. medical programs. These preliminary findings may help other programs articulate learning outcomes for their service-learning programs. Further, these preliminary findings may stimulate more systematic research (qualitative and quantitative) in this area.

Multiethnic perspectives on elder mistreatment.

PURPOSE: We conducted this study to understand the interpretations of elder mistreatment (EM) in multiethnic older adults. DESIGN AND METHODS: Focus group sessions were held with three ethnically homogenous groups (n = 18) and a group of elder care professionals (n = 6) eliciting responses to vignettes depicting various types of elder mistreatment. Qualitative analysis of focus group transcripts was performed to define EM occurrence, its severity, and to identify the perpetrator and victim. RESULTS: Four main categories emerged: social expectations, caregiver expectations, victim characteristics, and characteristics of the interaction. Themes included issues of gender roles, filial obligations, martial commitments, and ageism as features of the vignette discussions. Professional and lay caregiver issues were features of the caregiver expectations. Mental capacity, physical dependency, physical attributes, and complicity were the victim characteristics discussed. The characteristics of the interaction that were identified included resistance to care, retaliation, habitual occurrence, and perpetrator intent. IMPLICATIONS: Older adults identify multiple factors influencing the interpretation of elder mistreatment. These factors may determine strategies for future EM intervention.

Prevalence and 3-year incidence of abuse among postmenopausal women.

OBJECTIVES: We examined prevalence, 3-year incidence, and predictors of physical and verbal abuse among postmenopausal women. METHODS: We used a cohort of 91,749 women aged 50 to 79 years from the Women's Health Initiative. Outcomes included self-reported physical abuse and verbal abuse. RESULTS: At baseline, 11.1% reported abuse sometime during the prior year, with 2.1% reporting physical abuse only, 89.1% reporting verbal abuse only, and 8.8% reporting both physical and verbal abuse. Baseline prevalence was associated with service occupations, having lower incomes, and living alone. At 3-year follow-up, 5.0% of women reported new abuse, with 2.8% reporting physical abuse only, 92.6% reporting verbal abuse only, and 4.7% reporting both physical and verbal abuse. CONCLUSIONS: Postmenopausal women are exposed to abuse at similar rates to younger women; this abuse poses a serious threat to their health.