Knowledge of primary care nurses regarding domestic violence

Adherence to behavioural intervention in RCT study by the women experiencing domestic violence and attending ANC in a public hospital in India-an analysis

Background

The paper aims to identify the factors for effective implementation and adherence to the behavioural intervention package by women experiencing domestic violence (DV) and attending ANC in a public hospital.

Methods

A qualitative study was undertaken with 211 pregnant women experiencing DV and attending antenatal care (ANC) at the LN Hospital, New Delhi. The intervention was given to women recruited under the RCT study. The narratives were analysed under two broad themes, impeding and facilitating factors, with nine sub-themes.

Findings

Impeding factors are external factors generated by the structural interaction of the participants, whereas facilitating factors are supplied internally in the trial to eliminate the influence of impeding factors and singulate the factors under study. Our results show that despite the plethora of impeding factors (nine), the overall sum impact of impeding factors falls short of the positive impact of facilitating factors (nine), which were minor adjustments but reinforce participation in the trial and adherence with 97% follow-up rates.

Interpretation

Our study findings are expected to reset the treatment protocol, which entails converting impeding factors into facilitating factors for appropriate adherence and compliance and adequate access and utilization of public services. The sensitization of healthcare providers to the impact of the quality of human interaction on the patient and its impact on the uptake of healthcare services and adherence is needed, particularly in the public hospitals of India.

Funding

Funds received for the research are from the Indian Council of Medical Research (ICMR), New Delhi, Government of India.

Empowerment of nurses' knowledge and skills on violence against women with mental illness: A randomized controlled trail

BACKGROUND

Nurses play a key role in identifying and supporting women with abusive experiences. However, research that evaluated the effectiveness of educational interventions on violence against women is sparse from India.

AIM

To evaluate the effectiveness of a training program in improving nurses' knowledge and skills related to the identification and management of abused Women with Mental Illness (WMI).

METHODS

A randomized controlled trial design was adopted for the present study. A total of 68 nurses were randomly assigned to either the experimental or control group (34 in each group). The experimental group was provided eight interactive sessions based on a Nursing Module on abuse among women with mental illness. The assessments were done in both groups at baseline, after the intervention, at three months and six months. The data was collected using a self-rated questionnaire and case vignettes.

RESULTS

The mean knowledge score increased significantly in the experimental group after the intervention from 12.26 (SD, 2.03) to 23.60 (SD,1.24) and sustained at three months (23.07 ± 0.94) and six months (23.13 ± 1.61). Similarly, there were significant differences in nurses' skills after the training program (t = 13.17, p < 0.001) and at different time points of assessment (p < 0.001).

CONCLUSIONS

Results showed that training had a positive impact on nurses' knowledge and skills related to violence against women with mental illness. Therefore, it is necessary to provide continuous training on this issue to help nurses in providing holistic care to this vulnerable population.

Violence against women with mental illness and routine screening: Nurses' knowledge, confidence, barriers and learning needs

Violence against women is a major public health issue and women with mental illness (WMI) are at a double disadvantage. While nurses play a key role in identifying and responding to abused women, research is limited on this issue from India. This qualitative study was aimed to explore nurses' knowledge, confidence, and learning needs in the identification and responding to disclosure of abuse in women with mental illness. The focus group discussions were conducted among nurses (N = 21) working in psychiatry units at a tertiary care center. An interview guide with semi-structured questions was used to collect the data. Five dominant themes and fifteen sub-themes have emerged from qualitative analysis. The dominant themes include; Awareness of abuse among women with mental illness (AWMI), Experiences of recognizing and responding to abuse, Barriers for routine screening for abuse, Educational preparedness, and learning needs, and Prevention of abuse in women with mental illness. The identified barriers include personal related (personal discomfort, lack of knowledge, etc.), job related (Time consuming, not a nurse's job, lack of time, etc.) and organizational (lack of policies and administrative support, etc.). Most of the participants expressed that they lack confidence in the routine screening of women for abuse due to inadequate training. Therefore, it is critical to include a topic on domestic violence in the nursing curriculum and provide ongoing learning opportunities to the nurses through CNE programs, workshops, and conferences.

Physician experiences and barriers to addressing the social determinants of health in the Eastern Mediterranean Region: a qualitative research study

BACKGROUND

While it is increasingly recognized that social determinants influence the health of patients and populations, little is known about how doctors in the Eastern Mediterranean Region can help their patients with these issues. Our study aimed to identify common social challenges faced by patients in Eastern Mediterranean countries, to assess what doctors are already doing to address these challenges, and to identify barriers and facilitators for addressing the social causes of poor health in Eastern Mediterranean countries with shedding some light on how does this compare to a developed country like Canada.

METHODS

We conducted a qualitative research study employing qualitative descriptive methodology. A purposeful sample as well as snowballing technique were used to recruit 18 physicians who were trained in Eastern Mediterranean countries but have since moved to Canada. Recruitment continued until data saturation was reached. A content analysis was carried out after transcribing the interviews.

RESULTS

The main social challenges identified in clinical care in Eastern Mediterranean Regions include poverty, illiteracy, domestic violence, and food insecurity. Doctors attempted to help their patients by providing free medical services and free medications, establishing a donation box, and referring to social workers and support services, where available. Cultural constraints, lack of time, and unavailability of referral resources were often cited as important barriers. Our participants stated that Canada is generally better in dealing with the social challenges than their countries of origin.

CONCLUSIONS

Most study participants expressed their willingness to help patients in dealing with social challenges, and shared their experiences of tackling such issues, though there were also important barriers reported that would need to be overcome. Participants suggested that better addressing social challenges in clinical care would require educating both health care providers and patients about the importance of discussing the patient's social environment as part of the health care encounter, as well as advocating for broader policy approaches by governments to address the underlying social problems.