The Documentation of Family Violence in Healthcare and the Associations of Violence on Well-Being

Salla Kivelä

Research output: Book/ReportDoctoral thesisCollection of Articles


Family violence (FV) is a serious health problem worldwide, and Finland is one of Europe’s most violent places for women. FV refers to violence within the family between any family members, usually taking place in the home. In healthcare, the documentation of injuries is critically important, using the international classification of diseases (ICD) codes. Besides the required hospital care, FV has serious effects on the health and well-being of the whole family. The purpose of this study is to form a synthesis of the documentation of FV in healthcare and the associations of FV on individual well-being. The documentation and especially the use of the ICD codes in the FV patients’ care have not been described to this extent in previous research conducted in Finland. In addition, little is known about the family functioning and health of FV perpetrators or victims and the social support they receive in healthcare settings. Hence, it is essential to learn more about these issues and their evolution.

In total, the sample consisted of 1561 participants. The documentation and care of the hospitalised FV patients’ data (N = 1302) were collected twice from one Finnish central hospital database, using specific ICD-10 diagnostic codes, during the 10-year period from 1 January 2008 to 31 December 2017. The associations between FV and family functioning, health, and social support data (N = 259) were collected by using the Family Functioning, Health and Social Support (FAFHES) questionnaires from patients who visited a Finnish central hospital between October 2012 and April 2013, and follow-up surveys were collected from March 2015 to September 2015.

The analysis of the data, were performed using both qualitative and quantitative methods to obtain rich data. The analysis of the register based data was performed using content analysis, and the FAFHES questionnaires were analysed with statistical analyses (unadjusted analyses and linear regression model) using the IBM SPSS programme. As a result, 206 (13%) victims or perpetrators of FV were found. The risk of violence increased with the variables of female gender, young age, alcohol, and night-time. Various acts of violence were used, causing multiple injuries. The prevalence and roles of violence varied and changed during time. Family functioning was poor among the victims and participants whose violence had continued. Family health varied and seemed to be slightly poorer among women. Social support was found to be worse for the victims and participants who continued to experience or use violence. The documentation and coding was insufficient because only 34 (3%) visits were coded with a proper perpetrator code. The amount of perpetrator codes decreased, even though the general number of assault and physical violence coded visits increased.

To conclude, FV is a complex phenomenon, and various patients can have an FV background in different healthcare settings. The findings suggest a great need to improve documentation and coding in healthcare as an important part of good care. The study points to the importance of ensuring the overall well-being of FV patients or perpetrators, and their families. Healthcare professionals need the knowledge and skills to identify and intervene in FV. The findings should encourage healthcare, legal, and social service professionals to better identify and focus more broadly on the overall physical and mental well-being of the FV patients and their families. Thus, the well-being of individuals, families, and society can be improved.
Original languageEnglish
Place of PublicationTampere
PublisherTampere University
ISBN (Electronic)978-952-03-1407-1
ISBN (Print)978-952-03-1406-4
Publication statusPublished - 2020
Publication typeG5 Doctoral dissertation (articles)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028


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