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Simsek-Cetinkaya Ş, Evrenol Ocal S. "Psychological Injuries Are Not Visible": Experiences and Perceptions of Midwives and Nurses about Domestic Violence during Pregnancy. Clin Nurs Res 2023; 32:1115-1123. [PMID: 37345923 DOI: 10.1177/10547738231182190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
This study aimed to describe perceptions and experiences of nurses and midwives working in primary care about domestic violence (DV) in pregnancy. Data were collected by conducting in-depth face-to-face interviews with 10 midwives and 7 nurses working in seven family health centers between July 17 and August 28, 2020. Five main themes emerged: "The causes of domestic violence," "Difficulty recognizing domestic violence," "Obstacles to revealing domestic violence," "Obstacles to Assisting/Supporting domestic violence in pregnant women," and "Solutions to prevent domestic violence in pregnancy." Midwives/nurses feel inadequate and unprepared to recognize the symptoms of DV and to guide and support women and they are willing to take an active role in managing DV. It is recommended that they should be trained on DV, a monitoring system should be established including primary healthcare services and a measurement tool should be developed.
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Amel Barez M, Mirzaii Najmabadi K, Latifnejad Roudsari R, Mosavi Bazaz M, Babazadeh R. "Family and society empowerment": a content analysis of the needs of Iranian women who experience domestic violence during pregnancy: a qualitative study. BMC Womens Health 2023; 23:370. [PMID: 37438772 PMCID: PMC10339606 DOI: 10.1186/s12905-023-02525-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Domestic violence threatens maternal physical, psychological and emotional safety. Victim/survivor pregnant women required interventions based on their actual needs with the purpose of reducing domestic violence and its negative consequences. The present study aimed to explore the experiences of victimized Iranian pregnant women and identify their neglected needs. METHODS This qualitative descriptive study was performed from September 2019 to August 2021 in Mashhad, Iran. Semi-structured interviews with 14 women (8 pregnant and 6 after birth) who were the victims of domestic violence, and 11 key informants with various discipline specialties until the data saturation was achieved. Participants were selected through purposive sampling. Qualitative data were analyzed based on the conventional content analysis adopted by Graneheim & Lundman. FINDINGS The main theme emerging from the data analysis was "family and society empowerment" that implied the necessity of family, health system, legal, social and inter sectoral empowerment to reduce domestic violence during pregnancy. "Family and society empowerment" was comprised of three categories such as "need to empower couples to reduce domestic violence during pregnancy", "demand for improved health care services", and "need to strengthen inter-sectoral, legal and social supports". CONCLUSION Victim/survivor pregnant women experienced individual, interpersonal and inter sectoral needs. Family and society empowerment constituted the actual needs of victimized pregnant women. Awareness of policymakers and health system managers of these needs could be the basis for designing a supportive care program according to victim/survivor women's actual needs. In addition to the educational and skill empowerment of couples, it is essential that supportive organizations cooperate with each other to provide integrated and coordinated services to victim/survivor pregnant women and strengthen and facilitate their access to supportive resources.
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Affiliation(s)
- Malikeh Amel Barez
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
| | | | | | - Mojtaba Mosavi Bazaz
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Raheleh Babazadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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Vranda MN, Janardhana N, Kumar CN. Development of preparedness to respond to intimate partner violence scale among mental health professionals. J Neurosci Rural Pract 2023; 14:98-102. [PMID: 36891117 PMCID: PMC9945028 DOI: 10.25259/jnrp-2022-4-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Violence against women has been associated with serious health and mental health consequences. Health-care professionals play an important role in screening and providing care and support to victims of intimate partner violence (IPV) in the hospital setting. There is no culturally relevant tool to assess the mental health professional (MHP) preparedness to screen for partner violence in the clinical setting. This research aimed towards developing and standardizing scale to measure MHP preparedness and perceived skills in responding to IPV in the clinical setting. Materials and Methods The scale was field tested with 200 subjects using consecutive sampling at a tertiary care hospital. Results The exploratory factor analysis resulted in five factors constituting 59.2% of the total variance. The internal consistency Cronbach alpha 0.72 for the final 32-item scale was highly reliable and adequate. Conclusion The final version of the Preparedness to Respond to IPV (PR-IPV) scale measures MHP PR-IPV in the clinical setting. Further, the scale can be used to evaluate the outcome of IPV interventions in different settings.
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Affiliation(s)
- Mysore Narasimha Vranda
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Navaneetham Janardhana
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Hudspeth N, Cameron J, Baloch S, Tarzia L, Hegarty K. Health practitioners' perceptions of structural barriers to the identification of intimate partner abuse: a qualitative meta-synthesis. BMC Health Serv Res 2022; 22:96. [PMID: 35065630 PMCID: PMC8783157 DOI: 10.1186/s12913-022-07491-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Health care practitioners (HCPs) play a critical role in identifying and responding to intimate partner abuse (IPA). Despite this, studies consistently demonstrate a range of barriers that prevent HCPs from effectively identifying and responding to IPA. These barriers can occur at the individual level or at a broader systems or organisational level. In this article, we report the findings of a meta-synthesis of qualitative studies focused on HCPs' perceptions of the structural or organisational barriers to IPA identification. METHODS Seven databases were searched to identify English-language studies published between 2012 and 2020 that used qualitative methods to explore the perspectives of HCPs in relation to structural or organisational barriers to identifying IPA. Two reviewers independently screened the articles. Findings from the included studies were analysed using Thomas and Hardin's method of using a thematic synthesis and critiqued using the Critical Appraisal Skills Program tool for qualitative studies and the methodological component of the GRADE-CERQual. RESULTS Forty-three studies conducted in 22 countries informed the review. Eleven HCP settings were represented. Three themes were developed that described the structural barriers experienced by HCPs: The environment works against us (limited time with patients, lack of privacy); Trying to tackle the problem on my own (lack of management support and a health system that fails to provide adequate training, policies and response protocols and resources), Societal beliefs enable us to blame the victim (normalisation of IPA, only presents in certain types of women, women will lie or are not reliable). CONCLUSION This meta-synthesis highlights the need for structural change to address these barriers. These include changing health systems to enable more time and to improve privacy, training, policies, and referral protocols. On a broader level IPA in health systems is currently not seen as a priority in terms of global burden of disease, mortality and morbidity and community attitudes need to address blaming the victim.
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Affiliation(s)
- Naomi Hudspeth
- Department of General Practice, The University of Melbourne, Carlton, VIC, Australia
| | - Jacqui Cameron
- Department of General Practice, The University of Melbourne, Carlton, VIC, Australia.
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia.
| | - Surriya Baloch
- Department of General Practice, The University of Melbourne, Carlton, VIC, Australia
| | - Laura Tarzia
- Department of General Practice, The University of Melbourne, Carlton, VIC, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, VIC, Australia
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Carlton, VIC, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, VIC, Australia
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Hooker L, Taft A. Who is Being Screened for Intimate Partner Violence in Primary Care Settings? Secondary Data Analysis of a Cluster Randomised Trial. Matern Child Health J 2021; 25:1554-1561. [PMID: 33954881 DOI: 10.1007/s10995-021-03136-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess sociodemographic differences in postpartum women screened for intimate partner violence and who disclosed to their Maternal and Child Health nurses. METHODS Secondary analyses of survey data from women participating in a cluster randomised trial. The trial tested a nurse-designed, enhanced violence screening model-versus routine screening among eight community nurse clinics in Melbourne, Australia. Self-completion anonymous surveys were sent to all clinic attendees who had given birth in the previous eight months. We measured intimate partner violence with the Composite Abuse Scale and other sociodemographic variables. Multivariable logistic regression was used to analyse characteristics of screened versus unscreened women and those who did or did not disclose. RESULTS 91 clinics (163 nurses) participated in the trial. 2621/10,472 (25%) women responded to the survey. Notable characteristics, such as level of intimate partner violence (AdjOR 1.14, CI 0.94-1.40), parity (AdjOR 1.13, CI 0.94-1.35), education (AdjOR 1.20 CI 0.91-1.58) and being born in Australia (AdjOR 0.94, CI 0.86-1.03) made no significant difference to screening. However, nurses were significantly less likely to screen women with a lower income than those with a higher one (AdjOR 0.59, CI 0.40-0.87) with a dose response relationship. Women on the lowest levels of income were significantly more likely to disclose abuse (AdjOR 3.06, CI 1.02-9.17), indicating missed opportunities for nurses to provide timely care. CONCLUSIONS FOR PRACTICE Despite being required to screen all women, nurses are almost twice as likely to screen more affluent women, who would be less likely to be experiencing or disclose intimate partner violence.
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Affiliation(s)
- Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3086, Australia. .,Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3550, Australia.
| | - Angela Taft
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3086, Australia
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Fenne Fredriksen M, Nevland L, Dahl B, Sommerseth E. Norwegian midwives' experiences with screening for violence in antenatal care - A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 28:100609. [PMID: 33773144 DOI: 10.1016/j.srhc.2021.100609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 02/12/2021] [Accepted: 02/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study is to gain a better insight into and understanding of Norwegian midwives' experiences of screening for violence during antenatal care. METHODS We conducted a qualitative study of semi-structured interviews including midwives working in ten Norwegian municipalities. The interviews were analysed using systematic text condensation. RESULTS Four main themes can be drawn from the analysis. First, midwives found it difficult to raise the subject of violence, especially in the early phases of the screening programme. Second, the midwives were often provided with information about past experiences of violence, but little on ongoing violence. Third, according to the midwives, building trust was key to initiating direct questions about violence. Finally, more experience and collaboration reduced the barriers for raising the subject of violence. CONCLUSION Findings from this study suggest that screening for violence entails more than just asking a question. Furthermore, ongoing violence is difficult to identify, and women are more likely to relate stories of past violence. To overcome this issue, the midwives underlined the necessity to ask questions and have the capacity to listen to the potentially challenging answers. Findings from this study show that the training received by the midwives in relation to violence varied considerably. Hence, the study demonstrates the need for reinforced and standardised training in how to address violence in antenatal care.
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Affiliation(s)
- Mariann Fenne Fredriksen
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway
| | - Line Nevland
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway
| | - Bente Dahl
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway.
| | - Eva Sommerseth
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway.
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Chamberlain C, Gee G, Gartland D, Mensah FK, Mares S, Clark Y, Ralph N, Atkinson C, Hirvonen T, McLachlan H, Edwards T, Herrman H, Brown SJ, Nicholson AJM. Community Perspectives of Complex Trauma Assessment for Aboriginal Parents: 'Its Important, but How These Discussions Are Held Is Critical'. Front Psychol 2020; 11:2014. [PMID: 33041880 PMCID: PMC7522325 DOI: 10.3389/fpsyg.2020.02014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose Becoming a parent can be an exciting and also challenging transition, particularly for parents who have experienced significant hurt in their own childhoods, and may be experiencing ‘complex trauma.’ Aboriginal and Torres Strait Islander (Aboriginal) people also experience historical trauma. While the parenting transition is an important time to offer support for parents, it is essential to ensure that the benefits of identifying parents experiencing complex trauma outweigh any risks (e.g., stigmatization). This paper describes views of predominantly Aboriginal stakeholders regarding (1) the relative importance of domains proposed for complex trauma assessment, and (2) how to conduct these sensitive discussions with Aboriginal parents. Setting and Methods A co-design workshop was held in Alice Springs (Central Australia) as part of an Aboriginal-led community-based participatory action research project. Workshop participants were 57 predominantly Aboriginal stakeholders with expertise in community, clinical, policy and academic settings. Twelve domains of complex trauma-related distress had been identified in existing assessment tools and through community consultation. Using story-telling and strategies to create safety for discussing complex and sensitive issues, and delphi-style methods, stakeholders rated the level of importance of the 12 domains; and discussed why, by whom, where and how experiences of complex trauma should be explored. Main Findings The majority of stakeholders supported the importance of assessing each of the proposed complex trauma domains with Aboriginal parents. However, strong concerns were expressed regarding where, by whom and how this should occur. There was greater emphasis and consistency regarding ‘qualities’ (e.g., caring), rather than specific ‘attributes’ (e.g., clinician). Six critical overarching themes emerged: ensuring emotional and cultural safety; establishing relationships and trust; having capacity to respond appropriately and access support; incorporating less direct cultural communication methods (e.g., yarning, dadirri); using strengths-based approaches and offering choices to empower parents; and showing respect, caring and compassion. Conclusion Assessments to identify Aboriginal parents experiencing complex trauma should only be considered when the prerequisites of safety, trusting relationships, respect, compassion, adequate care, and capacity to respond are assured. Offering choices and cultural and strengths-based approaches are also critical. Without this assurance, there are serious concerns that harms may outweigh any benefits for Aboriginal parents.
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Affiliation(s)
- Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.,NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Perth, WA, Australia
| | - Graham Gee
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,School of Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | - Deirdre Gartland
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Fiona K Mensah
- Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sarah Mares
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,College of Medicine and Public Health, Flinders University, Darwin, NT, Australia
| | - Yvonne Clark
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.,SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Naomi Ralph
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
| | | | - Tanja Hirvonen
- College of Medicine and Public Health, Flinders University, Darwin, NT, Australia
| | - Helen McLachlan
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
| | - Tahnia Edwards
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - Helen Herrman
- Orygen, National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Stephanie J Brown
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia.,SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - And Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.,Population Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Hegarty K, McKibbin G, Hameed M, Koziol-McLain J, Feder G, Tarzia L, Hooker L. Health practitioners' readiness to address domestic violence and abuse: A qualitative meta-synthesis. PLoS One 2020; 15:e0234067. [PMID: 32544160 PMCID: PMC7297351 DOI: 10.1371/journal.pone.0234067] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/18/2020] [Indexed: 11/19/2022] Open
Abstract
Health practitioners play an important role in identifying and responding to domestic violence and abuse (DVA). Despite a large amount of evidence about barriers and facilitators influencing health practitioners' care of survivors of DVA, evidence about their readiness to address DVA has not been synthesised. This article reports a meta-synthesis of qualitative studies exploring the research question: What do health practitioners perceive enhances their readiness to address domestic violence and abuse? Multiple data bases were searched in June 2018. Inclusion criteria included: qualitative design; population of health practitioners in clinical settings; and a focus on intimate partner violence. Two reviewers independently screened articles and findings from included papers were synthesised according to the method of thematic synthesis. Forty-seven articles were included in the final sample, spanning 41 individual studies, four systematic reviews and two theses between the years of 1992 and 2018; mostly from high income countries. Five themes were identified as enhancing readiness of health practitioners to address DVA: Having a commitment; Adopting an advocacy approach; Trusting the relationship; Collaborating with a team; and Being supported by the health system. We then propose a health practitioners' readiness framework called the CATCH Model (Commitment, Advocacy, Trust, Collaboration, Health system support). Applying this model to health practitioners' different readiness for change (using Stage of Change framework) allows us to tailor facilitating strategies in the health setting to enable greater readiness to deal with intimate partner abuse.
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Affiliation(s)
- Kelsey Hegarty
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- The Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Gemma McKibbin
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Mohajer Hameed
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Koziol-McLain
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Gene Feder
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura Tarzia
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Leesa Hooker
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
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Gómez-Fernández MA, Goberna-Tricas J, Payá-Sánchez M. El saber experiencial de las matronas de Atención Primaria en la detección de violencia de género durante el embarazo. Estudio cualitativo. ENFERMERIA CLINICA 2019; 29:344-351. [DOI: 10.1016/j.enfcli.2019.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/11/2019] [Accepted: 05/19/2019] [Indexed: 11/25/2022]
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Fawole OI, Balogun BO, Adejimi AA, Akinsola OJ, Van Wyk JM. Training medical students: victim's perceptions of selectively screening women for intimate partner violence in health care settings. BMC MEDICAL EDUCATION 2019; 19:196. [PMID: 31185978 PMCID: PMC6558861 DOI: 10.1186/s12909-019-1627-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Routine IPV screening is a controversial topic and there is no evidence to suggest that it improves the health outcomes of women. Consequently, understanding the socio-cultural dimensions, becomes essential to ensure that victims receive appropriate and local support. This study was conducted to gather the perceptions of victims of IPV on the relevance of raising the topic at health care facilities and to determine specific categories of women to target for screening by medical personnel. It also explored how the information gathered could support victims and whether medical students should be trained on issues relating to IPV. METHODS Thirty-three key informant interviews were conducted among women attending clinics from three teaching hospitals in the Lagos, Oyo and Osun States of South West Nigeria. The hospitals offer antenatal, emergency, primary care and community outreach clinics which are well-attended by women. A six-item questionnaire assessed eligibility for participation in the study and participants were then purposively sampled. Interviews were conducted using a semi-structured guide. Ethical approval and gatekeepers' permissions were obtained, and each participant signed informed consent. Data was collected between June and November 2017. The data was entered into Excel and analysed deductively to answer each objective. RESULTS Most (n = 24) participants stated that medical practitioners should ask all women who present to health care facilities, about their experiences of IPV. Physically, medically and socially vulnerable women, including those in relationships with men in risky occupations, were identified as needing special attention and possible follow-up. They supported the use of the information within and outside of the health care facility, depending on the need of the woman. The majority (n = 24) indicated a need to train medical students about IPV and 19 participants suggested for the topic to be curriculated. Most victims favoured the inclusion of a multidisciplinary team in teaching medical students about IPV. CONCLUSIONS Victims of IPV were in support of initiatives to discuss the topic among some groups of female patients in health care settings. They thought it would enhance the quality of care (medical, psychological, legal and social) to victims. They identified an inter-professional team of stakeholders to include when training medical students about IPV.
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Affiliation(s)
- Olufunmilayo I. Fawole
- Department of Epidemiolgy and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Busola O. Balogun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adebola A. Adejimi
- Department of Community Medicine, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Nigeria
| | - O. J. Akinsola
- Department of Community Medicine and Primary Health Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Jacqueline M. Van Wyk
- Department of Clinical and Professional Practice, Nelson R. Mandela School of Medicine, University of Kwa-Zulu Natal, Durban, South Africa
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Lovi R, Hutchinson M, Hurley J. Inclusion of intimate partner violence-related content within undergraduate health care professional curriculum: mixed methods study of academics' attitudes and beliefs. Contemp Nurse 2018; 54:592-602. [PMID: 30303044 DOI: 10.1080/10376178.2018.1530946] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Undergraduate preparation is important in ensuring health care professionals are prepared to identify and respond to intimate partner violence (IPV). Previous studies confirm this education is highly variable and IPV-related content remains marginalised in undergraduate nursing, midwifery and paramedicine curricula. AIM To investigate frontline academics' attitudes and beliefs in relation to the inclusion of IPV-related content in the aforementioned degrees. DESIGN A large multi-phase mixed methods Australian case study of Australian undergraduate nursing, midwifery and paramedicine degrees. In this paper, components of the survey and interviews from this study will be reported on. METHODS Quantitative comparative analysis of a 51-item on-line survey and qualitative thematic analysis of guided conversational interviews. RESULTS Across Australian universities IPV remains poorly embedded in nursing, midwifery and paramedicine programmes. Academics report a range of barriers to such inclusion, including an already overcrowded curriculum, a lack of confident and competent academics to teach this content area and a lack of support for this content inclusion. One factor statistically significant in its association with non-inclusion of IPV-related content was academic attitudes of professional role resistance. Gender was also identified as a significant factor associated with non-inclusion and resistant professional attitudes. Qualitative interviews revealed that only six of the 18 participants identified IPV-related care as within their scope of practice, with professional role resistance a common theme identified. CONCLUSION Though professional organisation and policy makers now advocate for the inclusion of IPV-related content in the undergraduate preparation of nurses and midwives, work remains to address gendered and resistant attitudes amongst academics.
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Affiliation(s)
- Renee Lovi
- a School of Health and Human Sciences , Southern Cross University , Gold Coast Campus, Southern Cross Drive, Bilinga , QLD , Australia
| | - Marie Hutchinson
- b School of Health and Human Sciences , Southern Cross University , Hogbin Drive, Coffs Harbour , NSW 2450 , Australia
| | - John Hurley
- b School of Health and Human Sciences , Southern Cross University , Hogbin Drive, Coffs Harbour , NSW 2450 , Australia
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12
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Marques SS, Riquinho DL, Santos MCD, Vieira LB. Strategies for identification and coping with the violence situation by intimate partners of pregnant women. ACTA ACUST UNITED AC 2018; 38:e67593. [PMID: 29641681 DOI: 10.1590/1983-1447.2017.03.67593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 05/08/2017] [Indexed: 11/22/2022]
Abstract
Objective To know the strategies used by nurses of Units of Family Health Strategies to identify and cope with the violence situation by intimate partners of pregnant women. Method Descriptive study with a qualitative approach, in which semi-structured interviews were conducted with 23 primary care nurses from September 2015 to April 2016. Thematic content analysis was used. Results The category "It's very complex" has emerged - actions to identify and cope with the violence situation by intimate partners of pregnant women. Physical injuries were the main violence indicative identified at prenatal care. The coping strategies were the referrals to specialized services and joint discussion with healthcare team. Conclusion There's a need to organize a nursing protocol that helps in the identification and classification of risk exposure to violence, permanent education of these professionals and strengthening of intersectoral actions.
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Affiliation(s)
| | - Deise Lisboa Riquinho
- Departamento de Assistência e Orientação Profissional, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | - Maxuel Cruz Dos Santos
- Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
| | - Letícia Becker Vieira
- Departamento de Assistência e Orientação Profissional, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
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13
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Anderzen-Carlsson A, Gillå C, Lind M, Almqvist K, Lindgren Fändriks A, Källström Å. Child healthcare nurses' experiences of asking new mothers about intimate partner violence. J Clin Nurs 2018; 27:2752-2762. [PMID: 29274181 DOI: 10.1111/jocn.14242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To investigate child healthcare nurses' experiences of asking mothers of 8-month-old children about intimate partner violence using a two-step questionnaire. BACKGROUND Exposure to intimate partner violence is detrimental to women and to their children, and its early detection is vital. Child health care is a promising setting for detecting intimate partner violence. DESIGN The overall project had a quasi-experimental design and was employed in 2015 at 12 child healthcare centres in Sweden. The project aimed to test a two-step method for talking about intimate partner violence with mothers (n = 198) at the child healthcare centre. In this article, we disclose the experiences of the intervention from the perspective of the nurses (n = 13) who were educated and involved in the intervention. METHODS Data were collected by semi-structured interviews, analysed by thematic analysis. RESULTS Five categories emerged: using the two-step questionnaire method, asking about IPV as an important issue, being comfortable in the professional role and with asking about IPV, the importance of time and place in asking about IPV and spillover effects. CONCLUSIONS Asking mothers visiting the child health clinic about their experiences of intimate partner violence was seen as an important task. Using a questionnaire could facilitate asking, but the questionnaire must be short and easy to use. Furthermore, the time and place for initiating a talk about this sensitive topic must be carefully chosen. RELEVANCE TO CLINICAL PRACTICE The Violence in Families questionnaire was regarded as a useful tool and could thus be implemented in practice. However, it is important to offer education to the nurses prior to implementing a routine of asking about intimate partner violence in the child healthcare setting.
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Affiliation(s)
- Agneta Anderzen-Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden.,Faculty of Health, Science, and Technology, Department of Health Sciences, Nursing, Karlstad University, Karlstad, Sweden
| | - Cristina Gillå
- Central Child Health Unit, County Council of Varmland, Karlstad, Sweden
| | - Maria Lind
- Central Child Health Unit, Örebro County Region, Örebro, Sweden
| | - Kjerstin Almqvist
- Department of Social and Psychological studies, Karlstad University, Karlstad, Sweden
| | | | - Åsa Källström
- School of Law, Psychology and Social work, Örebro University, Örebro, Sweden
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Baird KM, Saito AS, Eustace J, Creedy DK. Effectiveness of training to promote routine enquiry for domestic violence by midwives and nurses: A pre-post evaluation study. Women Birth 2017; 31:285-291. [PMID: 29102526 DOI: 10.1016/j.wombi.2017.10.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/19/2017] [Accepted: 10/25/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Asking women about experiences of domestic violence in the perinatal period is accepted best practice. However, midwives and nurses may be reluctant to engage with, or effectively respond to disclosures of domestic violence due a lack of knowledge and skills. AIM To evaluate the impact of training on knowledge and preparedness of midwives and nurses to conduct routine enquiry about domestic violence with women during the perinatal period. METHOD A pre-post intervention design was used. Midwives and nurses (n=154) attended a full day workshop. Of these, 149 completed pre-post workshop measures of knowledge and preparedness. Additional questions at post-training explored participants' perceptions of organisational barriers to routine enquiry, as well as anticipated impact of training on their practice. Training occurred between July 2015 and October 2016. FINDINGS Using the Wilcoxon signed-rank test, all post intervention scores were significantly higher than pre intervention scores. Knowledge scores increased from a pre-training mean of 21.5-25.6 (Z=-9.56, p<0.001) and level of preparedness increased from 40.8 to 53.2 (Z=-10.12, p<0.001). Most participants (93%) reported improved preparedness to undertake routine enquiry after training. Only a quarter (24.9%) felt their workplace allowed adequate time to respond to disclosures of DV. CONCLUSIONS Brief training can improve knowledge, preparedness, and confidence of midwives and nurses to conduct routine enquiry and support women during the perinatal period. Training can assist midwives and nurses to recognise signs of DV, ask women about what would be helpful to them, and address perceived organisational barriers to routine enquiry. Practice guidelines and clear referral pathways following DV disclosure need to be implemented to support gains made through training.
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Affiliation(s)
- Kathleen M Baird
- Menzies Health Institute Queensland, Griffith University, Queensland 4131, Australia; School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia.
| | - Amornrat S Saito
- School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia
| | - Jennifer Eustace
- School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia
| | - Debra K Creedy
- Menzies Health Institute Queensland, Griffith University, Queensland 4131, Australia; School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia
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15
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LoGiudice JA. A Systematic Literature Review of the Childbearing Cycle as Experienced by Survivors of Sexual Abuse. Nurs Womens Health 2017; 20:582-594. [PMID: 27938798 DOI: 10.1016/j.nwh.2016.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 07/15/2016] [Indexed: 06/06/2023]
Abstract
For women who have experienced sexual abuse, the physical changes associated with pregnancy and the lack of control during birth can be catalysts for trauma from past abuse to resurface. This systematic review offers women's health care providers a thorough evaluation of the state of the science on survivors' childbearing experiences. The literature shows that lack of control, dissociation, and flashbacks are common themes. Re-experiencing of the trauma occurred during various stages of childbirth and was traumatizing to women. Nurses and other clinicians providing care to childbearing women can provide control to survivors during health care encounters and can form therapeutic relationships to help them have more positive childbirth experiences.
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Henriksen L, Garnweidner-Holme L, Thorsteinsen K, Lukasse M. 'It is a difficult topic' - a qualitative study of midwives´ experiences with routine antenatal enquiry for intimate partner violence. BMC Pregnancy Childbirth 2017; 17:165. [PMID: 28577361 PMCID: PMC5457554 DOI: 10.1186/s12884-017-1352-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 05/26/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) during pregnancy may jeopardize maternal and fetal health (IJFWM 49:159-164, 2004; IJGO 133:269-276, 2016). In recognition of the significant public health impact of IPV, the Norwegian Directorate of Health issued new guidelines in 2014, which recommend that health professionals routinely ask all women in antenatal care about their exposure to violence. The objective of this study was to gain an in-depth understanding of midwives' experiences with routine enquiry for intimate partner violence during the antenatal period. METHODS The study had a qualitative design. Individual semi-structured interviews with eight midwives providing antenatal care at eight Mother and Child Health Centres (MCHC) in Norway were conducted. Graneheim and Lundmans method of content analysis inspired the analysis. RESULTS Three main themes emerged: Midwives do ask about violence; It can be a challenge; and Factors that make it easier to ask. All midwives enquired, but not on a regular basis, about violence. The midwives' personal interest in the topic was an important factor that made it easier for them to ask about violence. Lack of time, fear of not knowing how to deal with a positive answer and lack of organizational support were barriers to asking pregnant women about their experiences of violence. CONCLUSION Midwives were aware of the guidelines and made some efforts to implement them. However, further education and organisational support is needed to enable midwives to routinely ask all pregnant women about IVP.
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Affiliation(s)
- L. Henriksen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus, University College of Applied Sciences, St. Olavs Plass, P.O. Box 4, 0310 Oslo, Norway
- Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway
| | - L.M Garnweidner-Holme
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus, University College of Applied Sciences, St. Olavs Plass, P.O. Box 4, 0310 Oslo, Norway
| | - K.K Thorsteinsen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus, University College of Applied Sciences, St. Olavs Plass, P.O. Box 4, 0310 Oslo, Norway
| | - M. Lukasse
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus, University College of Applied Sciences, St. Olavs Plass, P.O. Box 4, 0310 Oslo, Norway
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17
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LoGiudice JA. Dyspareunia in a Survivor of Childhood Sexual Abuse. J Midwifery Womens Health 2017; 62:215-219. [PMID: 28340508 DOI: 10.1111/jmwh.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 10/28/2016] [Accepted: 01/12/2016] [Indexed: 01/22/2023]
Abstract
Dyspareunia is a frequent chief concern encountered by midwives and other women's health care providers. There are many possible etiologies for dyspareunia, including a history of childhood sexual abuse, and approaching assessment in a holistic manner is necessary to identify the etiology. This case report presents evidence on the importance of screening a woman who presents with dyspareunia in a therapeutic manner to facilitate disclosure of sexual abuse. Best practices for screening for sexual violence, along with recommendations for providing gynecologic care to survivors, are offered. By understanding the long-term sequelae of sexual abuse and through screening all women, midwives and other women's health care providers can facilitate healing and treatment for survivors.
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Alexander KA, Volpe EM, Abboud S, Campbell JC. Reproductive coercion, sexual risk behaviours and mental health symptoms among young low-income behaviourally bisexual women: implications for nursing practice. J Clin Nurs 2016; 25:3533-3544. [PMID: 27272932 PMCID: PMC5565394 DOI: 10.1111/jocn.13238] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2016] [Indexed: 12/27/2022]
Abstract
AIMS AND OBJECTIVES To describe prevalence of reproductive coercion, sexual risk behaviours and mental health symptoms among women reporting lifetime sexual experiences with men and women compared to peers reporting sex exclusively with men. BACKGROUND Reproductive coercion, a global public health problem, is understudied among sexual minority women. Violence against women remains high among women who have sex with women and men. Rates of sexual and physical violence among this population are higher than women reporting exclusive sexual partnerships with either men or women. Nurses and other healthcare providers often do not conduct comprehensive sexual histories; assumptions related to a sex partner's gender may provide indications of broader health implications. DESIGN Cross-sectional survey of low-income Black women ages 18-25 recruited from six community-based sites for a parent study focused on intimate partner violence and health. METHODS We analysed survey data from participants who reported lifetime sexual experiences with men and women (N = 42) and compared their outcomes to those of women reporting sexual experiences with men only (N = 107). RESULTS A greater proportion of women who have sex with women and men reported experiencing reproductive coercion. Women who have sex with women and men also reported a greater number of lifetime intimate partner physical and sexual violence experiences, traded sex for resources, and had post-traumatic stress disorder symptoms. CONCLUSIONS Findings provide vital information that can inform nursing clinical practice, specifically related to history-taking, screening protocols and counselling strategies for intimate partner violence and mental health among women who have sex with women and men. RELEVANCE TO CLINICAL PRACTICE Strategies for addressing reproductive coercion and intimate partner violence as well as the health consequences among women who have sex with women and men in clinical and community-based settings should include a longitudinal understanding of sexual behaviour and gender of sex partners.
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Affiliation(s)
- Kamila A. Alexander
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Rm 456, Baltimore, MD 21205
| | - Ellen M. Volpe
- University at Buffalo, School of Nursing, 3435 Main St. Wende 200, Buffalo, NY, USA,
| | - Sarah Abboud
- University of Pennsylvania, School of Nursing, 418 Curie Blvd, Claire M. Fagin Hall, Philadelphia, PA 19104, USA,
| | - Jacquelyn C. Campbell
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Rm 436, Baltimore, MD 21205, USA,
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Byrskog U, Essén B, Olsson P, Klingberg-Allvin M. ‘Moving on’ Violence, wellbeing and questions about violence in antenatal care encounters. A qualitative study with Somali-born refugees in Sweden. Midwifery 2016; 40:10-7. [DOI: 10.1016/j.midw.2016.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 05/10/2016] [Accepted: 05/15/2016] [Indexed: 10/21/2022]
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Eustace J, Baird K, Saito AS, Creedy DK. Midwives' experiences of routine enquiry for intimate partner violence in pregnancy. Women Birth 2016; 29:503-510. [PMID: 27178111 DOI: 10.1016/j.wombi.2016.04.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/24/2016] [Accepted: 04/26/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Reducing violence against women is a national public health priority in Australia. Routine antenatal intimate partner violence screening by a skilled midwife is essential for assessment, support and appropriate referral, but can be challenging to implement. AIM To explore midwives' experiences of routine enquiry, perceptions of facilitators and barriers, and suggested strategies to improve practice. METHOD A qualitative descriptive design was used. Participants were recruited from an e-mail bulletin by the Australian College of Midwives. In-depth telephone interviews were conducted with 21 midwives. Data were analysed using an inductive thematic analysis approach. FINDINGS Three themes were identified: The first theme; Asking the Question incorporated the belief that whilst asking women about intimate partner violence were within the role of the midwife, participants felt unsupported and unprepared. The second theme; The big fear factor represented concerns around positive disclosures of intimate partner violence, including a sense of responsibility, worries about encouraging women to disclose without clear processes and resources to support them. The third theme; Building a relationship incorporated the importance of continuity of care, trust and rapport-building. Continuity of care was identified as a positive enabler for routine enquiry. A perceived lack of support, time pressures, and presence of a partner at appointments were all considered barriers to routine enquiry. CONCLUSION Routine enquiry about IPV is a valuable and important midwifery role. Midwives described frustration and fear when women disclosed violence. The perceived level of support from health services varied according to practice contexts and needs to be improved.
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Affiliation(s)
- Jennifer Eustace
- School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia
| | - Kathleen Baird
- Menzies Health Institute Qld, Griffith University, Queensland 4131, Australia; School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia.
| | - Amornrat S Saito
- School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia
| | - Debra K Creedy
- Menzies Health Institute Qld, Griffith University, Queensland 4131, Australia; School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia
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LoGiudice JA, Douglas S. Incorporation of Sexual Violence in Nursing Curricula Using Trauma-Informed Care: A Case Study. J Nurs Educ 2016; 55:215-9. [DOI: 10.3928/01484834-20160316-06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/28/2016] [Indexed: 11/20/2022]
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