Dissertation Defence: Paramedicine and Intimate Partner Violence: Investigation of an Underutilized Resource with Potential to Help Address a Public Health Pandemic

Rory Marshall, supervised by Dr. Paul van Donkelaar, will defend their dissertation titled “Paramedicine and Intimate Partner Violence: Investigation of an Underutilized Resource with Potential to Help Address a Public Health Pandemic” in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Kinesiology.

An abstract for Rory Marshall’s dissertation is included below.

Examinations are open to all members of the campus community as well as the general public. Registration is not required for in-person exams.

---

ABSTRACT

Introduction: Intimate partner violence (IPV) is a prevalent and detrimental public health pandemic. IPV, the use of physical, sexual, psychological, or coercive violence by a current or former intimate partner to exert power and control, causes harm to the health and well-being of survivors. As such, survivors of IPV often access and use resources to manage these circumstances. Paramedics, versatile and adaptable clinicians who function primarily in the emergency and primary care environments, may be useful to address public health needs surrounding IPV. However, the intersection of paramedicine and IPV is largely unexplored. Objective: to examine the intersection of paramedicine and IPV to generate new knowledge to facilitate evidence-based practice when paramedics are caring for survivors of IPV. Methods: This dissertation used a quantitative survey study to address paramedic readiness to encounter patients experiencing IPV, and three qualitative investigations conducted with survivors of IPV (interviews), IPV advocates (focus groups), and paramedics (focus groups) to examine the interactions between paramedic services and survivors of IPV. Descriptive statistics of readiness (7-point Likert) and the constructs of readiness were calculated and presented as mean±standard deviation. Separate inductive analysis of de-identified qualitative transcripts were performed using interpretive description approaches. Results: Overall paramedic readiness was 5.4±0.7 (N=693; mean construct scores: self-efficacy=4.8±1.0, emotional readiness=4.9±1.3, motivational readiness=6.5±0.6, and IPV knowledge=6.0±0.7). Survivors of IPV (N=9), IPV advocates (N=17), and paramedics (N=17) all identified the following challenges at the intersection of paramedicine and IPV: 1) patient-paramedic interpersonal interactions, 2) paramedic comfortability, familiarity, and self-efficacy with IPV, 3) paramedic service infrastructure for survivors of IPV, and 4) referral transitions to appropriate resources in-community and in-hospital. To address these challenges, participants reported that improved education, training, infrastructure, and policy is warranted. Conclusion: These results indicate service gaps exist at the intersection of paramedicine and IPV. Guided by these results, formal knowledge mobilization of concurrent education, training, infrastructure, and policy should be utilized to better serve survivors of IPV. With improved efforts, paramedics could evolve into expert resources for survivors of IPV.