Employment Experiences of Women Survivors of Intimate Partner Violence-related Brain Injury: What Is Happening, What Is Working, and How Support Professionals Can Do Better 1135

Research Objectives: This study (1) explored the intersection of intimate partner violence-related brain injury (IPV-BI) and employment; (2) identifed support needs, priorities, facilitators, and barriers to service delivery; and (3) generated recommendations for improved outcomes. Physical violence during IPV can cause neurological deficits, loss of consciousness, and brain injuries.1-6 IPV and BI are associated with elevated rates of unemployment, poverty, and homelessness, as well as increased mental health challenges.7-10 These social determinants of health impact women’s wellbeing through access to safe accommodations, food security, and disability supports,11 leaving them vulnerable to ongoing violence and permanent disability.

Design: Qualitative, semi-structured interviews lasting 60-90 minutes were conducted exploring: (a) survivors’ experiences of work; (b) perceived employment-related support needs; (c) existing support programs, policies, and practices; (d) valued characteristics of healthcare and social support services; and (e) systemic challenges to employment. Interviews were audio-recorded and transcribed verbatim. Ethical approval was granted by University of Toronto and Wilfrid Laurier University REBs.

Setting: Research took place in the general community.

Participants: Participants were purposively recruited from a national informal IPV-BI network,12 or through snowball sampling. Participants had to speak, read, and write in English, be aged 18 or older, and be able to provide legal consent. Twenty-four individuals participated: six women survivors, six executive director/program managers, seven direct service providers, and five employer/union representatives.

Interventions: Not applicable.

Main Outcome Measures: As the study was qualitative, a main outcome measure was not applied. Reported findings were formulated during the analysis process. Using a thematic analysis approach, descriptive codes were attached and then grouped into broad, topic-oriented categories.13,14 Memoing, reflexivity, and triangulation were used to enhance rigour. Trustworthiness was maintained through debriefing, analyst triangulation, regular meetings to discuss and ensure code consistency, and development of an audit trail.15

Results: Micro level findings present the lived experiences of women survivors, the importance of work, and practical challenges to obtaining and/or maintaining employment. They also explore what is working and what support professionals can do to improve outcomes.

Conclusions: IPV-BI is extraordinarily complex, with challenges experienced medically, emotionally, psychologically, economically, and socially. Survivors are subjected to complex and intensified layers of power and control, particularly within the workplace. Widespread knowledge gaps result in a critical need to increase awareness, develop practice guidelines, and train support professionals. Better understanding of IPV-BI and its impact on women’s employment, help-seeking behaviours, and access to care services is needed. This research addresses this gap, offering insight for support service design and delivery.

Author(s) Disclosures: No conflicts.