Skip to main content

Management of Victimized Patients in Greek Primary Care Settings: A Pilot Study

Abstract

The study explored the perceptions and practices of general practitioners (GPs) regarding the identification and management of victimized patients in primary care settings. A qualitative study was conducted employing three focus groups and a total of 18 GPs drawn from Greek General Practice Networks. Participants discussed issues of identification, assessment, recording, and referral of victimized patients at their clinical setting. Important points raised were the role ambiguity in the management of the victimized patients, the lack of confidence in diagnosing the problem, the discomfort in discussing Intimate Partner Violence (IPV) with their patients, the mistrust in the referral services, and the confidentiality issues affecting their recording practices. This preliminary information is expected to guide large-scale surveys and future interventions.

This is a preview of subscription content, access via your institution.

References

  • Alpert, E. J. (1995). Making a place for teaching about family violence in medical school. Academic Medicine, 70, 974–978.

    CAS  PubMed  Article  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.

    Article  Google Scholar 

  • Cohn, F., Salmon, M. E., & Stobo, J. D. (2002). Confronting chronic neglect: The education and training of health professionals on family violence. Washington, DC: National Academy Press.

    Google Scholar 

  • Elliott, L., Nerney, M., Jones, T., & Friedman, P. D. (2002). Barriers to screening for domestic violence. Journal of General Internal Medicine, 17, 112–116.

    PubMed Central  PubMed  Article  Google Scholar 

  • Garcia-Moreno, C. (2002). Dilemmas and opportunities for an appropriate healthservice response to violence against women. Lancet, 359, 1509–1514.

    CAS  PubMed  Article  Google Scholar 

  • Gerber, M. R., Leiter, K. S., Hermann, R. C., & Bor, D. H. (2005). How and why community hospital clinicians document a positive screen for intimate partner violence: a cross-sectional study. BMC Family Practice, 6, 48.

    PubMed Central  PubMed  Article  Google Scholar 

  • Gerbert, B., Abercrombie, P., Caspers, N., Love, C., & Bronstone, A. (1999a). How health care providers help battered women: the survivor’s perspective. Women & Health, 29, 115–135.

    CAS  Article  Google Scholar 

  • Gerbert, B., Caspers, N., Bronstone, A., Moe, J., & Abercrombie, P. (1999b). A qualitative analysis of how physicians with expertise in domestic violence approach the identification of victims. Annals of Internal Medicine, 131, 578–584.

    CAS  PubMed  Article  Google Scholar 

  • Gremillion, D. H., & Kanof, E. P. (1996). Overcoming barriers to physician involvement in identifying and referring victims of domestic violence. Annals of Emergency Medicine, 27(6), 769–73.

    Google Scholar 

  • Gutmanis, I., Beynon, C., Tutty, L., Wathen, C. N., & MacMillan, H. L. (2007). Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses. BMC Public Health, 7, 12.

    PubMed Central  PubMed  Article  Google Scholar 

  • Hamberger, L. K., Ambuel, B., & Guse, C. E. (2007). Racial differences in battered women’s experiences and preferences for treatment from physicians. Journal of Family Violence, 22, 259–265.

    Article  Google Scholar 

  • Hamilton, B., & Coates, J. (1993). Perceived helpfulness and use of professional services by abused women. Journal of Family Violence, 8(4), 313–331.

    Article  Google Scholar 

  • Harwell, T. S., Casten, R. J., Armstrong, K. A., Dempsey, S., Coons, H. L., & Davis, M. (1998). Results of a domestic violence training program offered to the staff of urban community health centers. Evaluation Committee of the Philadelphia Family Violence Working Group. American Journal of Preventive Medicine, 15, 235–242.

    CAS  PubMed  Article  Google Scholar 

  • Isaac, N. E., & Enos, V. P. (2001). Documenting domestic violence: How health care providers can help victims, National Institute of Justice Research in Brief. Washington, DC: National Institute of Justice.

  • Janssen, P., Dascal-Weichhendler, H., & McGregor, M. (2006). Assessment for intimate partner violence: where do we stand? The Journal of the American Board of Family Medicine, 19(4), 413–415.

    Article  Google Scholar 

  • Kyriopoulos, J. (1997). Equity or freedom in the market of health care services: The real political dilemma and the United Health Carrier (in Greek). In J. Kyriopoulos & A. Sissouras (Eds.), United health FOREAs: Necessity or delusion? Athens: Themelio Publications.

    Google Scholar 

  • Lapidus, G., Cooke, M., Gelven, E., Sherman, K., Duncan, M., & Banco, L. A. (2002). Statewide survey of domestic violence screening behaviors among pediatricians and family physicians. Archives of Pediatrics & Adolescent Medicine, 156, 332–336.

    Article  Google Scholar 

  • Leontidou, L. (1993). Informal strategies of unemployment relief in Greek cities: the relevance of family, locality and housing. European Planning Studies, 1(1), 43–68.

    Article  Google Scholar 

  • Lionis, C., Tziraki, M., Bardis, V., & Philalithis, A. (2004). Seeking quality improvement in primary care in Crete, Greece: the first actions. Croatian Medical Journal, 45, 509–603.

    Google Scholar 

  • Lionis, C., Symvoulakis, E. K., Markaki, A., Vardavas, C., Papadakaki, M., Daniilidou, N., et al. (2009). Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review. International Journal of Integrated Care, 9, 1–14.

    Google Scholar 

  • McNutt, L. A., Carlson, B. E., Gagen, D., & Winterbauer, N. (1999). Reproductive violence screening in primary care: perspectives and experiences of patients and battered women. Journal of the American Medical Women’s Association, 54, 85–90.

    CAS  PubMed  Google Scholar 

  • Mehta, P., & Dandrea, L. A. (1988). The battered woman [review]. American Family Physician, 37, 193–199.

    CAS  PubMed  Google Scholar 

  • Miller, D., & Jaye, C. (2007). GPs’ perception of their role in the identification and management of family violence. Family Practice, 24, 95–101.

    PubMed  Article  Google Scholar 

  • Minsky-Kelly, D., Hamberger, L. K., Pape, D. A., & Wolff, M. (2005). We’ve had training, now what? Qualitative analysis of barriers to domestic violence screening and referral in a health care setting. Journal of Interpersonal Violence, 20(10), 1288–1309.

    PubMed  Article  Google Scholar 

  • Muehlenhard, C. L., & Kimes, L. A. (1999). The social construction of violence: the case of sexual and domestic violence. Personality and Social Psychology Review, 3, 234–245.

    CAS  PubMed  Article  Google Scholar 

  • Nicolaidis, C., Curry, M. A., & Gerrity, M. (2005). Health care workers’ expectations and empathy toward patients in abusive relationships. Journal of the American Board of Family Practice, 18, 159–165.

    PubMed  Article  Google Scholar 

  • Oikonomidou, E., Anastasiou, F., Dervas, D., Patri, F., Karaklidis, D., Moustakas, P., et al. (2010). Rural primary care in Greece: working under limited resources. International Journal for Quality in Health Care, 22(4), 333–337.

    PubMed  Article  Google Scholar 

  • Papadakaki, M., Prokopiadou, D., Petridou, E., Kogevinas, M., & Lionis, C. (2012). Defining physicians’ readiness to screen and manage intimate partner violence in Greek primary care settings. Evaluation & the Health Professions, 35(2), 199–220.

    Article  Google Scholar 

  • Papadakaki, M., Tzamalouka, G. S., Chatzifotiou, S., & Chliaoutakis, J. (2009). Seeking for risk factors of intimate partner violence (IPV) in a Greek national sample. The role of self-esteem. Journal of Interpersonal Violence, 24(5), 732–750.

    PubMed  Article  Google Scholar 

  • Patton, M. Q. (1990). Qualitative evaluation and research methods (2nd ed.). Newbury Park: Sage.

    Google Scholar 

  • Petridou, E., Browne, A., Lichter, E., Dedoukou, X., Alexe, D., & Dessypris, N. (2002). What distinguishes unintentional injuries from injuries due to intimate partner violence: a study in Greek ambulatory care settings. Injury Prevention, 8, 197–201.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  • Ramsay, J., Richardson, J., Carter, Y. H., Davidson, L. L., & Feder, G. (2002). Should health professionals screen women for domestic violence? Systematic review. British Medical Journal, 325, 314.

    PubMed Central  PubMed  Article  Google Scholar 

  • Roelens, K., Verstraelen, H., Egmond, K., & Temmerman, M. (2006). A knowledge, attitudes, and practice survey among obstetrician-gynaecologists on intimate partner violence in Flanders, Belgium. BMC Public Health, 6, 238.

    PubMed Central  PubMed  Article  Google Scholar 

  • Short, L. M., Alpert, E., Harris, J. M., & Surprenant, Z. J. (2006). A tool for measuring physician readiness to manage intimate partner violence. American Journal of Preventive Medicine, 30, 173–180.

    PubMed Central  PubMed  Article  Google Scholar 

  • Strauss, A. L., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park: Sage Publications.

    Google Scholar 

  • Souliotis, K., & Lionis, C. (2005). Creating an integrated health care system in Greece: a primary care perspective. Journal of Medical Systems, 29(2), 187–196.

    CAS  PubMed  Article  Google Scholar 

  • Sugg, N. K., & Inui, T. (1992). Primary care physicians’ response to domestic violence. JAMA, 267, 3157–3160.

    CAS  PubMed  Article  Google Scholar 

  • Taft, A., Broom, D. A., & Legge, D. (2004). General practitioner management of intimate partner abuse and the whole family: qualitative study. BMJ, 328, 595–596.

    Article  Google Scholar 

  • Tower, L. E. (2006). Barriers in screening women for domestic violence: a survey of social workers, family practitioners, and obstetrician-gynecologists. Journal of Family Violence, 21, 245–257.

    Article  Google Scholar 

  • Tzamalouka, G. S., Parlalis, S. K., Soultatou, P., Papadakaki, M., & Chliaoutakis, J. E. (2007). Applying the concept of lifestyle in association with aggression and violence in Greek cohabitating couples. Aggressive Behavior, 33, 73–85.

    PubMed  Article  Google Scholar 

  • Valentine, N. B., Ortiz, J. P., Tandon, A., Kawabata, K., Evans, D. B., Christopher, J. L., et al. (2003). Patient experiences with health services: Population surveys from 16 OECD countries. In C. J. L. Murray & D. B. Evans (Eds.), Health systems performance assessment: Debates, methods and empiricism (pp. 643–652). Geneva: World Health Organization.

    Google Scholar 

  • Waalen, J., Goodwin, M., Spitz, A., Petersen, R., & Saltzman, L. (2000). Screening for intimate partner violence by health care providers. American Journal of Preventive Medicine, 19, 230–237.

    CAS  PubMed  Article  Google Scholar 

  • Weinreb, L., Fletcher, K., Candib, L., & Bacigalupe, G. (2007). Physicians’ perceptions of adult patients’ history of child abuse in family medicine settings. The Journal of the American Board of Family Medicine, 20(4), 417–419.

    Article  Google Scholar 

  • Wenzel, J. D., Monson, C. L., & Johnson, S. M. (2004). Domestic violence: prevalence and detection in a family medicine residency clinic. JAOA, 104(6), 233–239.

    PubMed  Google Scholar 

  • Zink, T., Regan, S., Goldenbar, L., Pabst, S., & Rinto, B. (2004). Intimate partner violence: what are physicians’ perceptions? The Journal of the American Board of Family Practice, 17, 332–340.

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

The project received a grant by the Research Committee of the University of Crete in Greece.

The authors would like to express their gratitude to the participants of the focus group discussions for sharing their valuable experiences and views.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maria Papadakaki.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Papadakaki, M., Petridou, E., Petelos, E. et al. Management of Victimized Patients in Greek Primary Care Settings: A Pilot Study. J Fam Viol 29, 371–379 (2014). https://doi.org/10.1007/s10896-014-9596-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10896-014-9596-3

Keywords

  • Intimate partner violence
  • IPV
  • Primary care
  • General practitioners
  • Abuse
  • Perceptions
  • Practice