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