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Biomedical subjects

Stephanie Pabst

Publications and source records attributed to Stephanie Pabst.

6 recordsLinked to original sources

A lifetime of intimate partner violence: coping strategies of older women.

Little is known about how older women cope in long-term abusive intimate relationships. Understanding their coping strategies may give insight into how to further support their effective coping efforts. Interviews were conducted with 38 women older than age 55 years. Grounded theory analysis demonstrated that women who remained in their abusive relationships employed mainly cognitive (emotion-focused) strategies to find meaning in a situation that was perceived as unchangeable. By reappraising themselves, their spouses, and their relationships they refocused energies in certain roles, set limits with their abusers, and reached out to others (friends, family, and community organizations). Some women appeared to thrive, others merely survived, but all maintained the appearance of conjugal unity.

Adaptation, Psychological↗

Older women's descriptions and understandings of their abusers.

Thirty-eight women who were in abusive relationships since age 55 years were interviewed to understand their abuse stories, ways of coping, and health care experiences. In responding to these questions, women described the nature of the abuse perpetrated by their elderly partners and tried to "make sense" of what they had experienced and to define "who" these men were. This took various forms, from personal theories about aging, to labels (ethnic stereotyping, demonizing, pathologizing) to characterizations of the abuser's private versus public behaviors. The authors explore the implications these findings have for assisting the elderly victim and perpetrator.

Aged↗

The prevalence and incidence of intimate partner violence in older women in primary care practices.

OBJECTIVE: Identify the incidence and prevalence of intimate partner violence (IPV) in women over 55 years of age in primary care offices. DESIGN: Telephone survey conducted between March and June 2003 by trained female interviewers who gathered self-report information about health and abuse. PATIENTS: A total of 3,636 women over 55 years of age had at least 1 visit in the past 12 months to primary care offices affiliated with an academic center in Southwestern Ohio were contacted by phone; 995 were deemed competent and completed the interview. INTERVENTION/INSTRUMENT: Thirty-eight page instrument that explored health, history of psychological (controlling behavior and threat of physical harm), physical, and sexual abuse since age 55 years. Interviews lasted 20 to 45 min. MAIN RESULTS: The mean age was 69 years (SD 8.35). Physical abuse in intimate relationships was reported by 1.52% since age 55 years (prevalence) and 0.41% in the past year (incidence). Prevalence and incidence rates for sexual abuse were 2.14% and 1.12%, threat of physical harm 2.63% and 1.62%, respectively. Less than half of the victims told someone else about the abuse. The mean number of health conditions was 3.84 for victims and 3.21 for nonvictims (P<.055) with significantly larger percentages of IPV victims reporting problems with chronic pain and depression. CONCLUSIONS: Physical and sexual abuse by an intimate partner does occur in women over 55 years, but rates are lower than those of younger women. Health care providers are reminded to think about IPV in older women and to ask about abuse as disclosure is rare.

Aged↗

Physician knowledge and management of children exposed to domestic violence in Ohio: a comparison of pediatricians and family physicians.

Active members of the Ohio chapters of American Academy of Family Physicians (FP=1,498) and American Academy of Pediatrics (Ped=1,725) were surveyed about their knowledge and management regarding children exposed to domestic violence (DV). Characteristics of respondents were analyzed by use of Chi-square analysis. Logistic regression was performed to identify predictors of DV knowledge and management. The response rate was 33.3%. Family physicians were more likely to know their local DV agency and recognize the adult symptoms of DV, such as unexplained injury. Pediatricians were more likely to report the child who saw a fight between parents to child protective services. Continuing work to increase physicians' comfort and ability to assess for DV and manage exposed children is needed.

Adult↗

Hidden victims: the healthcare needs and experiences of older women in abusive relationships.

BACKGROUND: Intimate partner violence (IPV) is a problem in older women, but older victims of IPV are often unidentified in the medical setting because providers think of IPV as a problem of younger women. The experiences of older women with IPV are unknown. This study reports on the healthcare experiences and needs of older victims of IPV. METHODS: Interviews were conducted with 38 women > 55 years who responded to an advertisement recruiting "women who had been in an abusive relationship since age 55." Interviews were audiotaped, transcribed, and analyzed for themes. RESULTS: The median age of participants was 58 years (range 55-90). The majority were Caucasian with annual incomes over dollar 40,000. The median relationship length was 24 years (range 2-67), and 39% remained in their abusive relationships. About half had discussed IPV with a healthcare provider. The themes that were identified included disclosure about IPV and both negative and positive experiences with healthcare providers. Reasons for nondisclosure were similar to those of younger women but were compounded by the generational mores of privacy about domestic affairs and society's lack of understanding and resources for IPV. Some of the women who disclosed IPV to their providers felt discounted and unsupported. Others reported receiving valuable help, including empathy, referrals to resources, assistance in naming the abuse, linking the stress of IPV to health, and respect for their decisions to continue their abusive relationships. CONCLUSIONS: Older women victims have difficulty initiating discussions about IPV with their providers. Providers are encouraged to identify signals of potential abuse and to create privacy with all patients to discuss difficult issues, such as IPV, and to be knowledgeable about appropriate referrals.

Aged↗

Intimate partner violence: what are physicians' perceptions?

BACKGROUND: Intimate partner violence (IPV) is common in primary care; 11% to 22% of women experienced physical abuse in the past year. Older women experience IPV as well, but it is often undetected. This study examined primary care providers' awareness about IPV in older women, including their screening practices and management. METHODS: Interviews and focus groups were conducted with 44 primary care providers. Thematic analysis was used to identify common themes. RESULTS: Providers fell along a continuum of thoroughness for identifying and managing IPV in older women, ranging from suboptimal to thorough identification of IPV and suboptimal to thorough management of the patient. In addition to the barriers commonly reported about IPV screening in younger women, providers described limited understanding of the diagnoses commonly associated with IPV, frustration with older women's unwillingness to disclose problems and ask for help, and limited community services that accommodate older women with IPV. Providers recommended that communities sponsor public awareness campaigns about IPV as a problem for all women and that aging and IPV agencies work together. CONCLUSIONS: Continued provider training about IPV should include information on identifying older victims and appropriate management options. Participants stressed the importance of community efforts to raise awareness and improve resources available for older women who are victims of IPV.

Attitude of Health Personnel↗