Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Objectives: The purposes of this exploratory study were to a) describe physical health symptoms and diagnoses in abused immigrant Latinas, b) explore the relationships between the women’s physical health and their experiences of intimate partner violence, their history of childhood trauma, and their immigration status, and c) explore the correlations between their physical health, health related quality of life (HRQOL), and mental health, specifically symptoms of post-traumatic stress disorder (PTSD) and major depressive disorder (MDD).

Methods: The convenience sample (n=33) for this cross-sectional descriptive study consisted of Latino women who were receiving emergency shelter and community-based services at a domestic violence services agency in the northeastern U.S. Pearson product-moment correlation coefficients were used to analyze the relationships between physical health variables and IPV type and severity, childhood and adulthood sexual abuse, and HRQOL.

Results: All of the women experienced threatened abuse. More than two-thirds of the women experienced moderate to severe psychological abuse, moderate to severe physical abuse, and/or sexual abuse. Twenty women experienced all three types. Women endorsed one or more items in neuromuscular (69.7%), gastrointestinal (63.6%), and genitourinary/gynecologic (45.5%) groupings. Pain was the most reported symptom: bodily pain in previous month (60%), repeated neck or back pain (54.5%), severe/frequent headaches (54.5%), and pelvic pain (21.2%). Eighty-one percent of women endorsed at least one pain item (mean=2.56) and the same number reported difficulty falling asleep or staying asleep. Pain and sleeping difficulty, the two most frequently reported symptoms, were consistently and highly correlated with PTSD and MDD diagnoses and symptom severity and HRQOL. Childhood sexual abuse was significantly correlated with total pain symptoms (r=0.606; p=0.000) and difficulty sleeping (from the PTSD scale) (r=0.349; p=0.046). Both pain (r=0.400; p=0.023) and sleeping difficulty (r=0.467; p=0.006) were also strongly correlated with undocumented immigration status.

Conclusion: Detailed assessment of patients with pain and sleep disorders can help identify IPV and its mental health sequelae, PTSD and MDD. Accurate identification of the root causes and pathways of the health burden carried by victims and survivors of IPV, who are vulnerable to persisting health problems without adequate healthcare, is critical in both clinical practice and research. [West J Emerg Med. 2010; 11(3): 248-252.]