Insufficient Readiness to Encounter Patients Experiencing Intimate Partner Violence and Intimate Partner Violence-Caused Brain Injury Among Paramedics: Alarm Bells for Implementing Education, Training, and Infrastructure

Purpose Survivors of intimate partner violence (IPV; synonymous with dating violence and partner abuse) frequently attempt to access and navigate the healthcare system. Paramedics commonly supersede the emergency department as the first contact. In Canada, absent national standards may impact paramedics readiness to care for patients experiencing IPV. Primary objective: measure the readiness of paramedics to encounter patients experiencing IPV. Secondary objectives: analyze factors that contribute to readiness, and compare IPV-caused brain injury (IPV-BI) knowledge as a component of readiness. Method Paramedics practicing in western Canada were eligible. The online survey included the READIness to encounter patients experiencing partner abuse (READI) Scale and IPV-BI knowledge items (both 7-point Likert). Descriptive statistics were calculated for total readiness (constructs), and IPV-BI knowledge. Factors affecting readiness were analyzed with a MANCOVA. Between construct differences were analyzed with an ANOVA (significance = p< 0.05). Results Paramedic (N = 693; Women = 48%, Men = 41%, Non-Binary and Not Listed = 1%, No Response = 10%) total readiness was 5.4 +/- 0.7 (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). The mean IPV-BI knowledge score was 4.4 +/- 1.0 (n=646). Gender (Women) and previous experience with IPV (Yes) each had medium positive effects on readiness (p <= 0.015). Differences between all constructs, and IPV knowledge and IPV-BI knowledge were observed (p<0.001, medium to extra large effect sizes), excluding self-efficacy versus emotional readiness (p=0.624). Conclusion Paramedics demonstrated moderate levels of readiness, with gender and previous IPV experience yielding main effects. IPV-BI knowledge scores were poor. Nationally mandated education, training, and infrastructure are required to ensure all survivors of IPV receive gold-standard care regardless of which paramedics are on duty.