Academic journal article Journal of Comparative Family Studies

Female and Male Medical Students' Exposure to Violence: Impact on Well Being and Perceived Capacity to Help Battered Women

Academic journal article Journal of Comparative Family Studies

Female and Male Medical Students' Exposure to Violence: Impact on Well Being and Perceived Capacity to Help Battered Women

Article excerpt

INTRODUCTION

My father beat me for the last time on the day I left home to attend medical school. Female medical student 1

What right do you have to ask me to talk to survivors of child abuse? I lived through that. Female medical student 2

My husband beat me throughout my family practice residency. My fellow residents saw the bruises on my arms and face. One was my physician. No one ever asked. Female family physician resident

Violence against women, within families and in the community, is a prevalent problem in our society. The single most common cause of injury to women is physical assault by male partners (Stark and Flitcraft, 1988), which occurs to about 1.8 million women per year (Straus and Gelles, 1986). Women who are victims of intimate partner violence are frequent consumers of health care services. For this reason the health care system is viewed as an essential component of a comprehensive community response to end violence against women. Physicians have a pivotal role to play in guiding this response. Their professional role affords them the opportunity to talk privately with women and develop a supportive relationship. As a result physicians are often able to identify and assist women who are experiencing intimate partner violence. However, physicians themselves are not immune from violence as the quotes above illustrate. A number of physicians have experienced child physical abuse, child sexual abuse, partner violence and sexual assault. These personal experiences with violence may impact a person's medical education and professional career. In this article we explore the impact that a personal history of violence has upon female and male medical students' current wellbeing, education, and perceived capacity to learn, and to assist battered women and other victims of family violence.

Partner violence has a substantial impact upon both women's health and women's use of the health care system. Women who have been physically abused by a partner, when compared with non-abused controls, are more likely to report their health as poor, are more likely to see the physician for medical and psychological concerns, and use more health care resources of all types (Koss, Woodruff and Koss, 1990; Koss and Heslet, 1992). In Bergman and Brismar's case control study (Bergman and Brismar, 1991), victims of partner violence experienced significantly elevated risk of all medical disorders, hospitalization and surgery when compared with non-abused matched control subjects. Risk was elevated for both trauma related problems (intentional injury), and non-trauma related problems, such as medical admissions, miscarriage, elective abortion, alcohol and drug problems, psychiatric problems, and suicide attempts. Johnson and Elliott (1997) found that compared to non-battered women, battered women made more doctors visits for episodic, symptom-related care, while non-battered women made more preventive health care visits, such as annual examinations.

Some studies have found an elevated risk of specific medical problems among women who are victims of violence. Saunders, Hamberger and Hovey (1993) reported that a diagnosis of depression or depressive symptoms significantly differentiated battered from nonbattered women. Other research demonstrates an association between victimization and musculoskeletal problems, headaches, somatization disorder, and post-traumatic stress (Cascardi, Langhinrichsen and Vivian, 1992; Koss and Heslet, 1992). Injuries from domestic violence fall disproportionately on women. Langhinrichsen-Rohling, Neidig, and Thorn (1995), for example, found that women were more likely than men to be injured from a domestic assault. In addition, Cascardi, Langhinrichsen and Vivian (1992) and Cantos, Neidig, and O'Leary (1994) found that women, compared to men, sustained more serious injuries from a domestic assault. Further research has found that women were more likely than men to seek health care services for domestic violence-related injuries (Stets and Straus, 1990). …

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