This month's cover photo evokes the isolation faced by victims of intimate partner violence (IPV). According to Karen Roush, PhD, RN, lead author of the study in this issue that reports on the perceptions of rural health care providers who care for these victims, "Isolation is one of an abuser's biggest weapons," especially for those who live in rural areas.
Roush says that several forms of isolation play a role in perpetuating abuse. In the rural setting, geographical factors can increase IPV victims' vulnerability by making it harder for them to seek or receive help. Neighbors' homes and populated places can be far away-and abusers often further isolate their victims by taking the car keys. If a victim calls 911, she might have to wait a long time for assistance to arrive.
Social and cultural factors also contribute to the isolation. In interviews with rural IPV victims, Roush found that many pointed to a "small-town culture" tendency to mind one's own business. "That came out a lot with the women I talked to: people would tell them afterward that they knew abuse was going on but didn't say anything," she says. Stigma surrounding IPV often causes outsiders to ignore it-and victims to feel too ashamed to tell others about it, leading to self-isolation. Additionally, women in rural areas tend to have less social support than those in urban areas. Roush notes that this is an issue of critical importance because "research shows that women who have social support are more likely to leave their abusers and to stay away and do better emotionally after leaving."
Health care providers are positioned to provide support for victims of IPV, but knowledge and practice gaps can lessen their ability to effectively do so. For more on this topic, read this month's original research CE, "Intimate Partner Violence: The Knowledge, Attitudes, Beliefs, and Behaviors of Rural Health Care Providers."-Diane Szulecki, Associate Editor