Awareness and Attitudes Towards Violence and Abuse among Emergency Nurses

An educational intervention study on mandatory reporting of intimate partner violence: changes in knowledge and attitudes among healthcare providers

BACKGROUND

Intimate partner violence (IPV) is a major public health concern. Healthcare providers can play a crucial role in reporting cases of IPV or suspected IPV injuries to the police or the criminal justice system, commonly referred to as mandatory reporting. However, mandatory reporting of intimate partner violence (MR-IPV) is a debated topic that can pose complex challenges for healthcare providers. This underscores the importance of training programs to ensure that healthcare providers can fulfill their MR-IPV obligations.

METHODS

We developed an educational intervention on MR-IPV and assessed its impact on healthcare providers' knowledge and attitudes. The study used a pre- and post-test design with three measurement points: baseline (T0), immediately after the intervention (T1), and six months later (T2). The intervention was conducted at a university college in Norway, with data collected between October 2022 and May 2023. The intervention was delivered to 37 healthcare providers who were currently part-time students in mental healthcare. Changes in knowledge and attitudes between T0 and T1, and T0 and T2 were analyzed through nonparametric tests on related samples using the Marginal homogeneity (Stuart-Maxwell) test. Risk differences (RD), along with their corresponding 95% confidence intervals (CI), were calculated for selected categories.

RESULTS

The number of participants knowing the MR law increased from 2.9% at baseline to 62.9% at T1 (RD = 0.60, 95% CI: 0.41-0.79) and to 31.4% at T2 (RD = 0.29, 95% CI: 0.11-0.46). The number of participants reporting knowing relevant criteria increased from 0.0% at baseline to 68.6% at T1 (RD = 0.69, 95% CI: 0.50-0.87) and to 34.3% at T2 (RD = 0.34, 95% CI: 0.16-0.53). We observed several persistent changes in healthcare providers' attitudes towards MR, including finding MR to be a useful instrument and generally complying with MR requirements.

CONCLUSIONS

The findings suggest that this educational intervention can have a positive impact on healthcare providers' attitudes and compliance with MR-IPV. Before the intervention, few participants reported knowing the MR law and its application criteria, demonstrating the importance of continuous learning and evidence-based training programs.

Attitudes of health professionals towards violence and their tendency to report spousal violence

The aim of this study is to determine the attitudes of primary care providers, physicians, nurses and midwives towards domestic violence and their tendencies to report violence against women and the affecting factors. The population of this study was 294 health professionals. The mean score on the Domestic Violence was 19.23 ± 4.28 and on the Scale of Health Professionals' Intentions/Behaviors Regarding Reporting Intimate Partner Violence was 124.24 ± 20.41. While the health professionals' attitudes towards domestic violence were more negative in our study, attitudes towards reporting violence against women were more positive. Also, health professionals faced ethical problems related to the principles of privacy and confidentiality.

Should domestic violence be or not a public crime?

BACKGROUND

Domestic violence has been addressed in public policies and law reforms in many countries to target its identification and provide increased support to those affected. In some countries, reporting domestic violence is mandatory, which means that anyone not only 'can' but also 'must' file a report, which is enough to progress the criminal proceedings, even against the victim's will. This article provides an overview about the importance of the clinicians' duty of care, debating whether or not domestic violence should be a public crime.

METHODS

A narrative review on the subject of mandatory reporting of domestic violence, conducting a search of PubMed.

RESULTS

Twenty studies were retrieved. Commonly victims agree with mandatory reporting. However, there are still several concerns voiced by both victims and health care workers that need to be further addressed.

CONCLUSION

This article addresses the importance and limitations of mandatory reporting while acknowledging the impact of these measures in both the victim and the accused.

Mandatory Reporting of Intimate Partner Violence: A Mixed Methods Systematic Review

As one of the efforts to prevent intimate partner violence (IPV) and intimate partner homicide, countries have adopted legislation requiring professionals to report cases of IPV, or suspected IPV injuries, to the police or the criminal justice system. The term for this is mandatory reporting. In spite of its good intention, mandatory reporting of IPV is a controversial issue. The objective of this review was to systematically search for, appraise the quality of, and synthetize the evidence from quantitative and qualitative studies on mandatory reporting of IPV. A systematic review of the scientific literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search was conducted through Ovid MEDLINE, PsycINFO, Scopus, Criminal Justice Abstracts, and SveMed+. Articles were included if they (a) were peer-reviewed empirical studies rather than theories or discussions, (b) described mandatory reporting of IPV, and (c) were written in English or Scandinavian languages. No time limit was applied. Twenty-five research studies met the criteria for review. Victims were generally supportive of a law requiring professionals to report IPV, although subsamples' attitudes opposing mandatory reporting were presented as main findings in a substantial number of studies. Group differences between abused or nonabused women and knowledge about mandatory reporting of IPV among professionals was mixed and inconclusive. Few professionals had actually reported IPV under mandatory reporting. Empirical research appears to be scarce, with moderate to high degree of bias and with only limited recent development.

Nursing Care Challenges of Child Violence Victims: A Qualitative Study

BACKGROUND

Violence against children is a serious global phenomenon. The severity of the injuries caused due to violence toward a child is sometimes so great that it sends them to the hospital. Nurses have the first contact with Child Violence Victims (CVVs). These nurses experience different challenges. This study was aimed at exploring nurses' experiences of challenges in care provision to CVVs.

MATERIALS AND METHODS

This conventional content analysis and qualitative study was conducted in 2018-2019. Using a purposive sampling method, 17 nurses with experience in care delivery to CVVs were recruited from among those working in Children's Medical Center, Tehran, Iran, and Bu-Ali Subspecialty Hospital, Ardabil, Iran. In-depth semi-structured interviews were conducted to collect the required data. Data were analyzed through the conventional content analysis method.

RESULTS

During data analysis, the 3 main categories of role conflict, lack of continuity of care, and emotional resentment and 9 subcategories were identified. Nurses experience challenges in care provision to CVVs. They do not have enough knowledge about CVVs, are unable to maintain the continuity of care, and experience role conflicts and emotional resentment.

CONCLUSIONS

Nurses experience some difficulties and challenges in the process of care delivery to CVVs. They tried to overcome emotional resentment, different conflicts, and concerns about the lack of continuity of care without adequate support and resources. Thus, planning to support nurses in this regard seems essential.

Effectiveness of a Module Based Training on Nurses' Attitude Towards Social Norms and Beliefs That Support Abuse Among women with Mental Illness

Violence against women is a priority public health issue. Women with mental illness are at a double disadvantage. While social norms and beliefs either support or confront violence against women, research is limited on this issue. A randomized controlled design was adopted for the present study. This study was aimed to evaluate the effectiveness of module-based training in changing nurses' attitudes towards norms and beliefs that support violence against women in mental health care settings. In this study, 68 nurses were randomly assigned to either the experimental or control group (34 in each group). After receiving the training program, the mean scores on norms and beliefs and justifiability of abuse scales were significantly higher in the experimental group compared to the control group (p < 0.05). The results confirmed the positive impact of the training program in changing nurses' attitudes. However, further studies are required to draw firm conclusions on the effectiveness of the training intervention.

How prepared are Myanmar's health care professionals in their response to gender-based violence?

Purpose

Gender-based violence (GBV) has negative impact on the health and well-being of the survivors. The initial response can lessen the magnitude of the effect, and thus the health care sector's readiness to respond to GBV cases is important. This study aimed to explore the knowledge, attitude and its association to practice regarding GBV response among health care personnel.

Design/methodology/approach

A cross-sectional study was conducted in 48 public hospitals in Yangon, Myanmar, involving 398 participants including doctors and nurses, by a self-administered structured questionnaire.

Findings

Among 398 participants, most of the participants had moderate level of knowledge, attitude and supportive environmental factors. Only 12.8% had experienced GBV management. The respondents with a bachelor's degree were more likely to practice on health care management towards GBV cases than those who finished with a diploma degree. The medical officers and senior medical officers were more likely to practice than the junior nurses. The participants who had already attended the trainings had more practice than those who had not. Those who work in the regional hospitals were less likely to practice than those who work in the station-level hospital.

Originality/value

This paper explored the associated factors to health care personnel's practice of health care management towards GBV survivors in Myanmar which contains information about knowledge, attitude and supportive environmental factors. The study results can be used for a supportive data for health system strengthening the response of GBV cases in Myanmar.

Occupational violence among female workers in an Iranian industrial area

Few studies have examined violence against female workers in the industrial sector. This study explored the prevalence of various types of violence and associated factors among female workers in the industrial sector. This descriptive survey was conducted in eleven industrial sites in Kashan, Iran, from April through September 2014. We used a 78-item questionnaire to obtain data from 817 female workers. More than half of the participants reported having experienced at least one type of violence. The prevalence rates of verbal aggression, sexual harassment, and physical violence were 52.5%, 12% and 11.5%, respectively. Single female workers (adjusted odds ratio [AOR] = 2.06, 95% CI = 1.09-4.27), and age older than 35 years were (AOR = 2.37, 95% CI = 1.26-2.93) each significantly related to increased odds of verbal violence. Short duration of employment (≤ five years) was the most strongly associated factor for sexual harassment (AOR = 2.82, 95% CI = 1.7-2.94). Working the night shift was significantly associated with encountering verbal violence (AOR = 2.79, 95% CI = 1.69-3.06). The high prevalence of violence suggests that management in industrial workplaces should invest time and resources in addressing violence. Developing a reporting procedure and training programs are recommended in dealing with workplace violence risk.

The Relationship between Nurses’ Recognition Regarding Elder Abuse and their Attitudes and Performance in Dealing with Elder Abuse Induced by Iranian Family Caregivers

Introduction:

Knowledge of nurses regarding elder abuse can be helpful in decisions about on-time and appropriate interventions. Our aim was to assess the relationship between recognition of nursing staff toward elder abuse and their attitudes, and performance in dealing with elder abuse induced by Iranian family caregivers.

Methods:

In this descriptive study, 400 nurses were selected, using cluster sampling, from nurses working in public or private hospitals in Iran. Data collection was performed using questionnaires measuring elder abuse symptom recognition, attitudes, and performance.

Results:

There is a significant relationship between the total scores for recognition of symptoms and elder abuse potential risk factors (p=0.05) and the nurses’ attitudes and performance scores (p = 0.001). There was no significant difference between the nurses’ performance and recognition scores (p = 0.14).

Conclusion:

Interventions to promote nurses’ recognition via in-service educational programs can improve nurses’ performance in different levels of abuse prevention and the quality of nursing care for the elderly.

Nurse education and understanding related to domestic violence and abuse against women: An integrative review of the literature

AIM

The aim of this study was to explore previous literature related to nurses understanding of Intimate partner violence (IPV) or domestic violence and abuse (DVA) against women and to identify the gaps in nursing education so as to use the findings as a baseline to inform potential intervention strategies, curriculum development and outline implications for future nursing practice.

DESIGN

An Integrative review of literature.

METHODS

Studies were extracted through a search of the electronic databases, such as Science direct, EBSCO host and PubMed, to identify relevant evidences published between January 2000-January 2017. "Joanna Briggs Institute (JBI) tool" was used to review primary research studies.

RESULTS

Seventeen empirical studies were analysed. Findings supported four themes including: educational and training experiences, identification of IPV/DVA, curriculum and communication skills of nurses. Continued efforts are further needed to highlight and address IPV/DVA in nursing education and training, to scale up nursing understanding to respond and identify IPV/DVA appropriately in a clinical environment.

A cross-sectional exploratory study of knowledge, attitudes, and practices of emergency health care providers in the assessment of child maltreatment in Maputo, Mozambique

BACKGROUND

In Mozambique, and other low-income countries (LICs), there is little information on the burden of child maltreatment (CM). Emergency care services (ECS) play an important role in recognizing, treating, and intervening in situations of CM. We aim to identify knowledge, attitudes, and practices regarding CM among health care providers in ECS at Mavalane General Hospital in Maputo, Mozambique.

METHODS

This exploratory cross-sectional study evaluates the knowledge, attitudes, and practices of health care providers to diagnose and treat cases of CM. A 25 min, pilot-tested verbal interview questionnaire was administered to 49 physicians and nurses working in ECS at Mavalane General Hospital. Interviews were completed between October-November 2010. Data were managed and analyzed in SPSS 14.0 and descriptive statistics were generated.

RESULTS

Of 49 health care providers, 83.6% reporting receiving no, or very little CM education or training. Only 61.2% had knowledge of physical abuse as a main form of child maltreatment and 38.8% were able to identify corresponding symptoms of physical abuse. Sexual abuse as a main form of CM was mentioned by 26.5 and 2% cited its symptoms. While 87.7% of health care providers strongly agreed or agreed that they hold an important role in preventing CM, 51.1% also strongly disagreed or disagreed that they feel confident diagnosing and treating CM cases. In regards to follow-up, 14.3% strongly disagreed or disagreed that they know where to refer victims for further follow-up and an additional 14.3% did not know whether they agreed or disagreed.

CONCLUSION

This study revealed knowledge gaps in emergency health care provider knowledge of the main forms of CM and their symptoms. The fact that a majority of health care providers in our sample did not receive information specific to CM in their medical education and training could explain this gap, as well as their unawareness of where to refer victims. Given that health care providers believe they play an important role in identifying and treating CM, future research should focus on raising physician awareness of CM and developing education and training materials grounded in cultural contexts to build response capacity in Mozambique and other LICs.