“It was over I thought, but then I had to deal with [the] judgement of professionals I should have felt safe with”: The Experiences of Survivors of Intimate Partner Violence Who Have Been Attended to by Paramedics

“It was over I thought, but then I had to deal with [the] judgement of professionals I should have felt safe with”: The Experiences of Survivors of Intimate Partner Violence Who Have Been Attended to by Paramedics

Introduction: Intimate partner violence (IPV) persists as a severe and prevalent criminal, social, and health issue, most commonly affecting women. Survivors of IPV frequently engage with the healthcare system to access treatment, support, and resources. Paramedics commonly encounter patients experiencing IPV, either knowingly or unknowingly. However, how paramedics manage such cases is largely unknown.

Objective: To examine how the perspectives and experiences of survivors of IPV who have been attended to by paramedics can inform our understanding of current practices.

Methods: An interpretive description qualitative approach was used. Self-identified English-speaking women (18+ years) who reported a history of IPV and being attended to by paramedics for IPV-caused reasons were eligible to complete an online survey as part of a larger study. In addition to eligibility confirming and demographic items, the survey included a free text box for participants to describe their experiences being attended to by paramedics. Free text data responses were analyzed (NVivo) for patterns and mobilized into themes.

Results: Twelve women (Alberta 50%(6/12), British Columbia 42%(5/12), Saskatchewan 8%(1); 35±10 years; Race=multiselect, White 50%(6/12), Asian=25%(3/12), Black=25%(3/12), Indigenous=8%(1/12); Middle Income 50%(6/12), Low Income 50%(6/12); type of IPV=multiselect, Physical IPV 83%(10/12), Emotional IPV 75%(9/12), Sexual IPV 42%(5/12), Stalking 25%(3/12), Other IPV 33%(4/12)) responded to the survey, between 01/12/2023 and 25/02/2024. Four prominent themes emerged from the perspectives and experiences of participants: 1) inappropriate approaches and clinical decision making from paramedics, 2) concurrent positive and negative dynamics from police involvement, 3) disbelief by paramedics at the extent and authenticity of violence and injuries, and 4) repeated IPV and recurring paramedic attendance.

Conclusions: Frequently, participants reported the attitudes and aptitudes surrounding IPV of paramedics may have yielded insufficient situation and injury recognition, leading to subsequent inadequate response. The presence of police may layer complexity for paramedics, as varied interactions were reported. As survivors were commonly seen by paramedics repeatedly, multiple opportunities to provide appropriate care exist. Development of education, training, and infrastructure must be actioned to situate paramedics to deliver appropriate management in situations involving IPV. If properly positioned and equipped, paramedics could become expert resources for survivors of IPV.