000 02560nab a22002657a 4500
999 _c7761
_d7761
005 20250625151619.0
008 220809t2019 -nz||||| |||| 00| 0 eng d
040 _aAFVC
100 _91206
_aGear, Claire
245 _aExploring sustainable primary care responses to intimate partner violence in New Zealand :
_cClaire Gear, Jane Koziol-McLain and Elizabeth Eppel
_bqualitative use of complexity theory
260 _bBMJ,
_c2019
500 _aBMJ Open, 2019, 9(11): e031827
520 _aObjective To explore what affects sustainable responses to intimate partner violence within New Zealand primary care settings using complexity theory. Design Primary care professional interviews on intimate partner violence as a health issue are analysed using a complexity theory-led qualitative research methodology grounded in poststructuralism. Setting Four general practices in one region of the North Island of New Zealand, two serving a general patient population and two adopting an indigenous approach. Participants Seventeen primary care professionals and management from the four recruited general practices. Results The complex adaptive system approach the ‘Triple R Pathway’, calls attention to system interactions influencing intimate partner violence responsiveness across health system levels. Four exemplars demonstrate the use of the Triple R Pathway. Two key system areas challenge the emergence of primary care responsiveness: (1) Non-recognition of intimate partner violence as a key determinant of ill-health. (2) Uncertainty and doubt. Conclusions The relationship between intimate partner violence and ill-health is not well recognised, or understood in New Zealand, at both policy and practice levels. Inadequate recognition of socioecological determinants of intimate partner violence leads to a simple health system response which constrains primary care professional responsiveness. Constant intervention in system interactions is needed to promote the emergence of sustainable responses to intimate partner violence. (Authors' abstract). Record #7761
650 _aDOMESTIC VIOLENCE
_9203
650 _aHEALTH SERVICES
_9290
650 _aINTERVENTION
_9326
650 _aINTIMATE PARTNER VIOLENCE
_9431
651 4 _aNEW ZEALAND
_92588
700 _91511
_aKoziol-McLain, Jane
700 _aEppel, Elizabeth
_96867
773 0 _tBMJ Open, 2019, 9(11): e031827
830 _aBMJ Open
_94846
856 _uhttps://doi.org/10.1136/bmjopen-2019-031827
_zDOI: 10.1136/bmjopen-2019-031827 (Open access)
942 _2ddc
_cARTICLE