Disclosure of intimate partner violence experiences during COVID-19: patient-provider communication in a Southern United States emergency department

ABSTRACT

Using the lens of Communication Privacy Management (CPM) theory, this article examines communication between health care providers in the southern United States emergency department (ED) and patients who have experienced IPV. We qualitatively examine communicative challenges that COVID-19 protocols have created, as well as routine difficulties that occur when communicating with survivors of violence. The participants described challenges including: (1) Feeling uncertainty, (2) Encountering patient resistance, (3) Managing apathy and frustration, and (4) Navigating time pressure. Furthermore, the providers explained how COVID-19 compounded those challenges through: (1) Minimizing contact, (2) Losing nonverbal behavior, (3) Encountering limited resources, and (4) Facing visitor complications. This article extends CPM theory by exploring disclosure challenges related to IPV in health care settings during the COVID-19 pandemic including permeability, linkages, and privacy rules. It offers practical suggestions for increasing patient disclosure of IPV experiences.

KEYWORDS:

• Intimate partner violence
• Communication Privacy Management Theory
• patient-provider communication
• COVID-19

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 It is important to note that in the state where this data was collected, a change in state law in 2017 removed the requirement by healthcare professionals to notify law-enforcement about victim-survivors of IPV. Prior to that date, health care providers had an obligation to report victim-survivors of IPV to law enforcement. However, after 2017, health care providers have an obligation to provide local resources but can no longer report to law enforcement if the patient does not agree.

2 At the hospital included in this study, if the patient was suspected to have COVID-19 or had tested positive for COVID-19 during their visit in the ED, the patient would be given an iPad to communicate with the provider. Both the provider and patient were still physically at the hospital, but they were using telehealth to communicate.

Additional information

Funding

This work was supported by the Department of Communication Development Funds.