Women's perspectives on intimate partner violence services: the hope in Pandora's box.

OBJECTIVE To explore women's perspectives about how to enhance services for those who experience intimate partner violence (IPV) and how to improve the links between such services and the health care setting. METHODS We conducted 6 focus groups involving 67 women in both rural and urban settings in North Carolina. A standardized interview guide was used to investigate the women's perspectives on the study objectives. Coding and theme analyses were conducted to assess new ideas and/or common themes among the groups. RESULTS Participants identified currently available services for women experiencing IPV, including health care providers, police and the legal system, domestic violence shelters, and churches. Participants discussed existing barriers to addressing violence within the health care system, including cost of medical services, risk of having social services remove their children, violence being too personal to discuss, and doctors' inability to provide what they thought victims really needed. Participants agreed that the most important role for providers would be referrals to useful services (advocacy, job training, and financial support). Participants also emphasized the need for community-based prevention efforts. CONCLUSION We found a striking lack of support among women participants in our study for using the health care setting as part of the service response to IPV. Participants believed that the health care system is not set up to allow providers to provide the level of individual assistance that they thought would be most useful. Participants did have hope that women's risk of future IPV would decrease if they were provided with useful community-based services and if community-wide prevention efforts were implemented.