Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2016

Open Access 01-12-2016 | Research article

A qualitative study exploring midlife women’s stages of change from domestic violence towards freedom

Authors: June Keeling, Debbie Smith, Colleen Fisher

Published in: BMC Women's Health | Issue 1/2016

Login to get access

Abstract

Background

Domestic Violence (DV) remains a significant global health problem for women in contemporary society. Existing literature on midlife women’s experiences of domestic violence is limited and focuses on health implications. Leaving a violent relationship is a dynamic process that often requires multiple attempts and separations prior to final termination. The aim of this study was to explore the process of leaving a violent relationship for midlife women.

Methods

This qualitative study involved fifteen women aged between 40–55 who had accessed residential and non-residential community support services for domestic violence within the UK. Community-based support agencies provided these women with access to letters of invitation and participant information sheet explaining the study. The women notified agency staff who contacted the research team to arrange a mutually convenient time to meet within a safe place for both the women and researchers. It was stressed to all potential participants that no identifiable information would be shared with the agency staff. Women were considered survivors of DV if they defined themselves as such. Data were gathered through semi structured interviews, transcribed verbatim and thematically analysed.

Results

Midlife women appear to differ from younger women by transitioning quickly though the stages of change, moving rapidly through the breaking free onto the maintenance stage. This rapid transition is the resultant effect of living with long-term violence causing a shift in the women’s perception towards the violent partner, with an associated reclamation of power from within the violent relationship. A realisation that rapid departure from the violence may be critical in terms of personal safety, and the realisation that there was something ‘wrong’ within the relationship, a ‘day of dawning’ that had not been apparent previously appears to positively affect the trajectory of leaving.

Conclusions

Midlife women appeared to navigate through the stages of change in a rapid linear process, forging ahead and exiting the relationship with certainty and without considering options. Whilst these findings appear to differ from younger women’s process of leaving, further research is needed to explore and understand the optimum time for intervention and support to maximise midlife women’s opportunities to escape an abusive partner, before being reflected appropriately in policy and practice.
Appendix
Available only for authorised users
Literature
1.
2.
Home Office. Call to End violence against women and girls. Action plan. In. Edited by Government HMs. London; 2011.
3.
Hall P. Intimate violence: 2009/10 BCS. In: Smith K, editor. Homicides, Firearm Offences and Intimate Violence 2009/10 Supplementary Volume 2 to Crime in England and Wales 2009/10, vol. 2. London: Home Office; 2011. p. 71.
4.
Home Office. Ending violence against women and girls in the UK. In. Edited by Office H. London: Home Office; 2014.
5.
Keeling J, Birch L, Green P. Pregnancy Counselling Clinic; a questionnaire survey of intimate partner abuse. J Fam Plann Reprod Health Care. 2004;30(3):165–8.CrossRefPubMed
6.
Keeling J, Wormer K. Social worker interventions in situations of domestic violence: what we can learn from survivors’ personal narratives. Br J Soc Work. 2011;41:1–17.CrossRef
7.
Holta S, Buckley H, Whelan S. The impact of exposure to domestic violence on children and young people: a review of the literature. Child Abuse Negl. 2008;32(8):797–810.CrossRef
8.
Lazenbatt A, Devaney J, Gildea A. Older women’s lifelong experience of domestic violence in Northern Ireland. In: CAP-FUNDED RESEARCH PROJECT REPORT. Belfast: Queen’s University Belfast; 2010.
9.
Taylor DK, Bacuwa G, Evans J, Jackson-Johnson V. Assessing barriers to the identification of elder abuse and neglect: a communitywide survey of primary care physicians. J Natl Med Assoc. 2006;98(3):403–4.PubMedPubMedCentral
10.
LeBlanc KD, Weeks LE. Are transition houses equipped to meet the needs of women in midlife and older? J Fam Violence. 2013;28:535–45.CrossRef
11.
Roberto KA, McPherson MC, Brossoie N. Intimate partner violence in late life. A review of the empirical literature. Violence Against Women. 2013;19(12):1538–58.CrossRefPubMed
12.
Mazza D, Dennerstein L, Garamsvegi CV, Dudley EC. The physical, sexual and emotional violence history of middle-aged women: a community--based prevalence study. Med J Aust. 2001;175:199–201.PubMed
13.
Loxton D, Schofield M, Hussain R. Psychological health in midlife women who have ever lived with a violent partner or spouse. J Interpers Violence. 2006;21(8):1092–107.CrossRefPubMed
14.
Sormanti M, Shibusawa T. Intimate partner violence among midlife and older women: a descriptive analysis of women seeking medical services. Health Soc Work. 2008;33(1):33–41.CrossRefPubMed
15.
Wilke DJ, Vinton L. The nature and impact of domestic violence across age cohorts. Affilia. 2005;20(3):316–28.CrossRef
16.
Farham B. What is midlife? Contin Med Educ. 2006;24(11):666.
17.
Willis SL, Reid JB. Life in the Middle: Psychological and Social Development in Middle Age. California, USA: Academic; 1999.
18.
Loxton D, Schofield M, Hussain R, Mishra G. History of domestic violence and physical health in midlife. Violence Against Women. 2006;12(8):715–31.CrossRefPubMed
19.
Scali J, Gandubert C, Ritchie K, Soulier M, Ancelin M-L, Chaudieu I. Measuring resilience in adult women using the 10-items Connor-Davidson Resilience Scale (CD-RISC). Role of trauma exposure and anxiety disorders. PLoS ONE. 2012;7:e39879.CrossRefPubMedPubMedCentral
20.
Brim OG, Ryff CD, Kessle RC. How Healthy Are We? A National Study of Well-Being at Midlife. Chicago: The University of Chicago Press; 2004.
21.
Pico-Alfonso MA, Echeburua E, Martinez M. Personality disorder symptoms in women as a result of chronic intimate partner violence. J Fam Violence. 2008;23:577–88.CrossRef
22.
Ford-Gilboe M, Wuest J, Varcoe C, Davies L, Merritt-Gray M, Campbell J, et al. Modelling the effects of intimate partner violence and access to resources on women’s health in the early years after leaving an abusive partner. Soc Sci Med. 2009;68:1021–9.CrossRefPubMed
23.
Romito P, Turan JM, Marchi MD. The impact of current and part interpersonal violence on women’s mental health. Soc Sci Med. 2005;60:1717–27.CrossRefPubMed
24.
Wolkenstein BH, Sterman L. Unmet needs of older women in a clinic population: the discovery of possible long-term sequelae of domestic violence. Prof Psychol Res Pract. 1998;29(4):341–8.CrossRef
25.
Johnson MP. Patriarchal terrorism and common couple violence: two forms of violence against women. J Marriage Fam. 1995;57(2):283–94.CrossRef
26.
27.
Stark E. Coercive control: How men entrap women in personal life. New York: Oxford University Press; 2007.
28.
Martin AJ, Berenson KR, Griffing S, Sage RE, Madry L, Bingham LE, et al. The process of leaving an abusive relationship: the role of risk assessments and decision-certainty. J Fam Violence. 2000;15(2):109–21.CrossRef
29.
Bostock J, Plumpton M, Pratt R. Domestic violence against women: understanding social processes and women’s experiences. J Community Appl Soc Psychol. 2009;19(2):95–110.CrossRef
30.
Brown J. Working toward freedom from violence: the process of change in battered women. Violence Against Women. 1997;3(5):5–26.CrossRefPubMed
31.
Rusbult CE, Martz JM. Remaining in an abusive relationship: an investment model analysis of nonvoluntary dependence. Pers Soc Pscychol Bull. 1995;21:558–71.CrossRef
32.
Grigsby N, Hartman BR. The barriers model: an integrated strategy for intervention with battered women. Psychotherapy. 1997;34:485–97.CrossRef
33.
34.
Straus MA. Measuring intrafamily conflict and violence: the Conflict Tactics (CT) scale. J Marriage Fam. 1979;41(1):74–85.CrossRef
35.
Taft C, Schumm J, Orazem RJ, Meis L, Pinto LA. Examining the link between posttraumatic stress disorder symptoms and dating aggression perpetration. Violence Vict. 2010;25(4):456–69.CrossRefPubMed
36.
Dutton MA, Green BL, Kaltman SI, Roesch DM, Zeffiro TA, Krause ED. Intimate partner violence, PTSD and adverse health outcomes. J Interpers Violence. 2006;21:955–68.CrossRefPubMed
37.
Reisenhofer S, Taft A. Women’s journey to safety - the transtheoretical model in clinical practice when working with women experiencing intimate partner violence: a scientific review and clinical guidance. Patient Educ Couns. 2013;93(3):536–48.CrossRefPubMed
38.
Burman S. Battered women; stages of change and other treatment models that insigate and sustain leaving. Battered Women. 2003;3(1):83–98.
39.
Bell KM, Naugle AE. Understanding stay/leave decisions in a violent relationships: a behavior analytic approach. Behav Soc Issues. 2005;14:21–45.CrossRef
40.
Prochaska JO, Diclemente CC. Transtheoretical therapy: toward an integrative model of change. J Consult Clin Psychol. 1982;5:390–5.
41.
Wuest J, Merritt-Gray M. Not going back: sustaining the separation in the process of leaving abusive relationships. Violence Against Women. 1999;5:110–33.
42.
Rhatigana DL, Street AE, Axsomc DK. A critical review of theories to explain violent relationship termination: implications for research and intervention. Clin Psychol Rev. 2006;26(3):321–45.CrossRef
43.
Robinson L, Spilsbury K. Systematic review of the perceptions and experiences of accessing health services by adult victims of domestic violence. Health Soc Care Community. 2008;116(1):16–31.
44.
Shurman LA, Rodriquez CM. Cognitive-affective predictors of women’s readiness to end domestic violence relationships. J Interpers Violence. 2006;21:1417–39.CrossRefPubMed
45.
Campbell JC, Webster D, Koziol-McLain J, Block C, Campbell D, MA MAC. Risk factors for femicide in abusive relationships: results from a multisite case control study. Am J Public Health. 2003;93:1089–907.CrossRefPubMedPubMedCentral
46.
Davis R. “The Strongest Women”: exploration of the inner resources of abused women. Qual Health Res. 2002;12(9):1248–63.CrossRefPubMed
47.
van Manen M. Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. USA: New York Press; 1990.
48.
49.
50.
World Health Organisation. Putting women’s safety first: Ethical and safety recommendations for research on domestic violence against women. 2001.
51.
Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006;18(1):59–82.CrossRef
52.
Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle VS, King M, editors. Existential phenomenological alternatives for psychology. New York: Oxford University Press; 1978.
53.
Schneider EM. Battered women and feminist lawmaking. New Haven, CT: Yale University Press; 2000.
54.
Keeling J, Fisher C. Women’s early relational experiences that lead to domestic violence. Qual Health Res. 2012;22(1):1559–67.CrossRefPubMed
55.
Keeling J. Exploring women’s experiences of domestic violence: injury, impact and infant feeding. Br J Midwifery. 2012;20(12):736–41.CrossRef
56.
Gordon KC, Burton S, Porter L. Predicting the intentions of women in domestic violence shelters to return to partners: Does forgiveness play a role? J Fam Psychol. 2004;18:331–8.CrossRefPubMed
57.
Pape KT, Arias I. The role of perceptions and attributions in battered women’s intentions to permanently end their violent relationships. Cogn Ther Res. 2000;24:201–14.CrossRef
58.
Sulak TN, Saxon TF, Fearon D. Applying the theory of reasoned action to domestic violence reporting behavior: the role of sex and victimization. J Fam Violence. 2014;29(2):165–73.CrossRef
59.
Kearney MH. Enduring love: a grounded formal theory of women’s experience of domestic violence. Res Nurs Health. 2001;24(4):270–82.CrossRefPubMed
60.
Merritt-Gray M, Wuest J. Counteracting abuse and breaking free: the process of leaving revealed through women’s voices. Health Care Women Int. 1995;16:399–412.CrossRefPubMed
61.
Anderson DK, Saunders DG. Leaving an abusive partner. An empirical review of predictors, the process of leaving, and psychological well-being. Trauma Violence Abuse. 2003;4(2):163–91.CrossRefPubMed
Metadata
Title
A qualitative study exploring midlife women’s stages of change from domestic violence towards freedom
Authors
June Keeling
Debbie Smith
Colleen Fisher
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2016
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-016-0291-9

Other articles of this Issue 1/2016

BMC Women's Health 1/2016 Go to the issue

Research article

Biological factors that place women at risk for HIV: evidence from a large-scale clinical trial in Durban

Research article

Endometriosis and its global research architecture: an in-depth density-equalizing mapping analysis

Research article

Contraceptive use, knowledge, attitude, perceptions and sexual behavior among female University students in Uganda: a cross-sectional survey

Research article

Gender at the intersection with race and class in the schooling and wellbeing of immigrant-origin students

Research article

Analysis of the diagnostic value of CD138 for chronic endometritis, the risk factors for the pathogenesis of chronic endometritis and the effect of chronic endometritis on pregnancy: a cohort study

Research article

Barriers and facilitators for clinical trial participation among diverse Asian patients with breast cancer: a qualitative study