| dc.description.abstract | The lifetime prevalence of intimate partner violence (IPV) in Canada is estimated
to be 25% (Ellsberg & Heise, 2005; Seager, 2003). Survivors of IPV report experiencing
sleep difficulties (M. A. Woods, & Hampton, 2008) that impact their health, subsequently
increasing health service use (Bonomi, Andreson, Rivara, & Thompson, 2009; Colten &
Altevogt, 2006; Moorcroft, 2005; Rosa, 2006; Soares, 2005). Being able to isolate the
effect of IPV on health service and long term sleep disruption may shed light on the
economic as well as social cost of IPV to society. The purpose of the present study was to
measure the relationship between sleep, IPV, and health service use in a sample of
survivors of IPV from Alberta, Saskatchewan, and Manitoba, participating in the Healing
Journey Project (Social Sciences and Humanities Research Council/Community
University Research Alliance). The Healing Journey Project is a longitudinal study
including seven waves of data collection, and the data from the current study was drawn
from Waves 1, 2, and 4. At Wave 1, 665 women participated in the study, with 595
women participating at Wave 2 and 484 at Wave 4. A subsample of 205 women who had
not been in a violent intimate partner relationship since Wave 2 was created at Wave 4 to
test two of the hypotheses. Overall, three hypotheses were tested: (1) sleep problems due
to abuse predict frequency of health service utilization, (2) survivors of IPV experience
long term sleep problems due to abuse, and (3) that long term health service use
frequency is predicted by long term sleep problems due to abuse. The following
information was collected to test these hypotheses: demographic characteristics (age,
working status, educations status, presence of children in the home, childhood abuse, and
cultural background), symptoms of post-traumatic stress disorder (PTSD) as assessed using the Post-traumatic Stress Disorder Checklist (Blanchard, Jones-Alexander,
Buckley, & Forneris, 1996; Weathers, Litz, Herman, Huska, & Keane, 1993), depression
symptoms as assessed using a short form of the Center for Epidemiological Studies
Depression Scale (Andresen, Carter, Malmgren, & Patrick, 1994; Radloff, 1977), selfreport
ratings of health status, number of injuries in the previous 12 months, IPV as
assessed using the Composite Abuse Scale (Hegarty, Bush, & Sheehan, 2005), sleep
problems due to abuse as assessed using a brief measure of sleep problems in survivors of
IPV, and reports of frequency of health service access in the previous 12 months. The
three hypotheses were each tested using hierarchical multiple regression. The second
hypothesis was also tested using frequency counts and comparison between reports of
sleep problems due to abuse at Waves 2 and 4. The first hypothesis, that sleep problems
due to abuse predicated health service use, and the third hypothesis, that sleep problems
due to abuse predicted long-term health service use, were both rejected. The second
hypothesis, that past abuse predicted long-term sleep problems due to abuse, was
supported. The findings suggest that health service use is not related to sleep problems
due to abuse, despite evidence that survivors of IPV experience significant disruption to
their sleep as a result of the violence. It appears that while survivors of IPV are not using
health services in association with sleep problems due to abuse that clinicians should
avoid over-treating sleep problems in survivors of IPV as not sleeping may be a
protective strategy when victims of IPV are avoiding sleep to avoid danger (Colten &
Altevogt, 2006; Stepanski, 2006). The implications of these findings and future direction
are discussed. | en_US |
