Women's victimization history and surgical intervention

AORN Journal,  Jan, 2003  by Debra Pilling Hastings,  Glenda Kaufman Kantor

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* Are women who are victims of abuse as children, victims of IPV as adults, or victims of abuse as children and adults likely to experience a greater number of psychological and physical symptoms than women who have not experienced abuse or have experienced fewer types of victimization in their lives?

* Is there a higher incidence of numbers of surgeries undergone by women who are survivors of abuse?

* Are women who are victims of abuse as children, victims of IPV as adults, or both more likely to undergo specific types of surgical intervention than women who have experienced no abuse or fewer types of victimization in their lives?

SAMPLE

This study represents a secondary analysis of intake record data from a sample of 130 patients (ie, 65 patients with a history of abuse and a control group of 65 patients with no history of abuse). Patients from an adult primary care practice in rural, northern New England self reported a history of abuse either as a child, as an adult in an intimate relationship, or both in their intake records. (31) Sixty-five patients identified themselves as victims of abuse. This includes 57 adult women and eight adult men ranging in age from 21 to 87 years (mean [M] = 46.08, standard deviation [SD] = 14.90). The original researchers, who studied male and female participants, selected a control group of patients from the primary care practice by matching records for age and gender with the abused group. Patients in the control group did not disclose experience of abuse in their records. The control group consisted of 53 women and 12 men ranging in age from 17 to 88 years (M = 46.83, SD = 15.45). The sample was drawn from a practice of 905 patients in a small, predominantly Caucasian community.

For this study, researchers chose to include only data reported by female patients in their analysis because IPV is, for the most part, victimization against women, (32) and women are more likely than men to experience psychological and physical injuries from domestic abuse. (33) The findings from this study reflect data from women only (ie, n = 57 for the abused group, n = 53 for the control group). The decision to eliminate men from the study, based on the belief that the health issues of women and men, as well as the use of health services, may be quite different, accounts for the size difference of the two groups.

Human participants protection. Before commencement of the original study, permission to conduct data analyses was granted by the ethics committee of the hospital where the primary care practice is located. Patient identities were protected carefully. In preparation for analysis by the researcher, relevant sections of individual medical records, specifically personal responses to the questionnaires completed by the patients, were reviewed and photocopied by the patients' physician or nurse practitioner. The health care providers were employed in the primary care practice and also were part of the original research team. At that time, any personal or identifying information in the record was eliminated. The original records and files never were referred to again. Data entry was the sole responsibility of one researcher from outside the practice who did not have access to patient identifiers. Neither the name of the hospital nor the community in which the data were collected has been revealed in any reference to the study. The current researchers never have seen any patient identifiers associated with the data used in this or any other related study.