In addition to injuries sustained during violent episodes, physical and psychological abuse are linked to a number of adverse physical health effects including arthritis, chronic neck or back pain, migraine and other frequent headaches, stammering, problems seeing, sexually transmitted infections, chronic pelvic pain, stomach ulcers, spastic colon, and frequent indigestion, diarrhoea, or constipation.
(Family Violence Prevention Fund 1999 [http://www.fvpf.org])
The short-, medium- and long-term effects of domestic abuse on health were discussed in Chapter 2. This chapter will focus on specific health needs including emergency care, mental health intervention, pregnancy, rape, sexual assault, and aspects related to the health and well-being of children. It explores the role of specialist healthcare groups including staff working in Accident and Emergency settings, GP practice settings, paediatrics, obstetrics and gynaecology, community and other acute care settings.
In all areas of healthcare, staff meet clients who have experienced, or are experiencing, abuse within an intimate relationship. Therefore, staff at every level of an organization ought to have an understanding of domestic abuse and its implications for the clients and the care they require. There should also be other staff with more detailed knowledge relevant to explicit situations such as emergency care, follow-up care or community care.
When discussing or analysing any aspect of domestic abuse it is important to take into account the mounting feminist discourse on the subject which emphasizes the implications of the wider social origins of abuse. Historically, in seeking to explain domestic abuse, research studies have concentrated on the actions or mind-sets of the individual woman (victim) or abuser, or on their interactions with one another. With such a focus, studies then may fail to acknowledge the substantial impact that gender inequalities play in the overall state of affairs.
Whilst it may be informative for practitioners to analyse psychological and social characteristics of the individual, it is equally important to appreciate that to do so without accepting the wider picture minimizes the problems faced by those being abused. More-