Why do certain primary health care teams respond better to intimate partner violence than others? A multiple case study

Abstract

Objective: To analyse how team level conditions influenced health care professionals' responses to intimate partner violence.

Methods: We used a multiple embedded case study. The cases were four primary health care teams located in a southern region of Spain; two of them considered "good" and two s "average". The two teams considered good had scored highest in practice issues for intimate partner violence, measured via a questionnaire (PREMIS - Physicians Readiness to Respond to Intimate Partner Violence Survey) applied to professionals working in the four primary health care teams. In each case quantitative and qualitative data were collected using a social network questionnaire, interviews and observations.

Results: The two "good" cases showed dynamics and structures that promoted team working and team learning on intimate partner violence, had committed social workers and an enabling environment for their work, and had put into practice explicit strategies to implement a women-centred approach.

Conclusions: Better individual responses to intimate partner violence were implemented in the teams which: 1) had social workers who were knowledgeable and motivated to engage with others; 2) sustained a structure of regular meetings during which issues of violence were discussed; 3) encouraged a friendly team climate; and 4) implemented concrete actions towards women-centred care.

Keywords: Análisis de redes sociales; Atención centrada en la mujer; Case study; Equipos de atención primaria; Estudio de caso; Intimate partner violence; Primary health care team; Social network analysis; Violencia de compañero íntimo; Women-centred care.