April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Disclosure and Privacy During COVID-19: Health Care Provider Communication with Survivors of Intimate Partner Violence
Intimate partner violence (IPV) is defined as “physical violence, sexual violence, stalking, or psychological harm by a current or former partner or spouse” (Center for Disease Control [CDC], 2020). During the COVID-19 pandemic, the prevalence of IPV has increased (Boserup et al., 2020; Cannon et al., 2021), with some citing an increase in exacerbation of mental health problems as one of the reasons (Cannon et al, 2021). Indeed, there are some estimates that due to quarantines and lockdowns IPV has increased globally up to 20 percent (Cannon et al., 2021). Health care providers, and especially those working in emergency departments (ED), can play an important role in the screening, identification, prevention, and communication of patients who are experiencing IPV (NICE, 2014). Furthermore, routine screenings in the ED can be very significant since patients who experience IPV tend to go to the ED as a common place for treatment due to its 24-hour availability. Communicating with patients who experience IPV is necessary because it can assist with the recognition of IPV survivors, potentially reduce future abuse, and improve treatment for patients (Bair-Merritt et al., 2014; Taft et al., 2013). However, evidence suggests that low numbers of survivors are actually identified by health care providers (McGarry & Nairn, 2015). Moreover, health care providers often encounter challenges related to disclosure and privacy in their communication with patients who experience IPV. Patients may not want to disclose that they are survivors of abuse and sometimes health care providers do not know how to effectively communicate about IPV with patients (O’Campo et al., 2011; Waalen et al., 2000 Thus, using the lens of Communication Privacy Management (CPM) theory, this article examines communication between health care providers in the ED and patients who have experienced IPV to explore disclosure challenges. We qualitatively examine communicative challenges that have arisen due to COVID-19 protocols, as well as routine difficulties that occur when communicating with patients reluctant to self-identify as survivors of violence. The health care providers described challenges including: 1) feeling uncomfortable, 2) patient’s response, 3) frustration, 4) apathy, and 5) aspects of time. Furthermore, the providers explained how those challenges are compounded by COVID-19 through: 1) minimizing contact, 2) loss of patient’s nonverbal behavior, 3) personal protective equipment (PPE), 4) telemedicine, 5) limited resources, and 6) visitor complications. This article extends CPM theory by expanding conceptions of context and catalyst criteria in disclosure challenges related to IPV in health care settings during the COVID-19 pandemic. For example, the results showed that several of the stated challenges that the providers themselves discussed included their own risk-benefit analysis regarding how they would seek disclosure from patients and how persistently they would potentially encourage patients to disclose. Additionally, the paper offers practical implications for health care provider communication with survivors such as appropriate communication training and COVID-19 protocol revision considerations. The contributions of this article offer a detailed look at a relatively understudied topic and offer important theoretical/practical implications for communication theory generally and CPM theory specifically.