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Öhman A, Vives-Cases C, Edin K. 'Important, but difficult': Swedish primary care professionals' perceptions and experiences of dealing with violence against women: an interview study. BMC PRIMARY CARE 2024; 25:258. [PMID: 39014330 PMCID: PMC11251211 DOI: 10.1186/s12875-024-02489-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/25/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Men's violence against women is a global health problem causing physical, mental, sexual and reproductive ill-health. The World Health Organisation has estimated that every third woman in the world has been exposed to physical and/or sexual violence. Swedish primary care is central for victims of violence, as it is normally the first port of call for seeking healthcare. This requires professional competence on violence, and its causes. It also requires resources for working with violence prevention, disclosure and supportive actions. The aim of this study is to deepen the understanding of how primary care professionals in Sweden deal with violence against women. We analyse their viewpoints, experiences and practices of working with violence as a health problem, and especially if, and if so how, they ask patients about violence. METHODS A qualitative, explorative research design was adopted. Research interviews were conducted with 18 health professionals at eight primary care clinics. These clinics were located in four different regions, from the south to the north, in large urban areas, middle-size cities and rural areas. The interviews were voice recorded and transcribed verbatim. Thematic analysis was used to analyse the interviews. RESULTS Three themes, with a total of ten related sub-themes, were developed. These themes are: (a) Varying understandings and explanations of violence against women; (b) The tricky question of asking about violence; and (c) Multiple suggestions for improving primary care's work with violence against women. The awareness of violence varied considerably, with some practitioners being highly knowledgeable and having integrated violence into their everyday practice, whereas others were less knowledgeable and had not paid much attention to violence. The very naming of violence seemed to be problematic. Several suggestions for improvements at professional, managerial and organisational levels were articulated. CONCLUSIONS The results shed important light on the professionals' problems and struggles when dealing with violence against women in primary care. Better support and resources from the healthcare organisation, clearer leadership and more detailed policy would improve and facilitate everyday practice. All of these factors are indispensable for primary care's work with victims of men's violence against women.
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Affiliation(s)
- Ann Öhman
- Umeå Centre for Gender Studies, Umeå University, Umeå, SE-90187, Sweden.
| | - Carmen Vives-Cases
- Dept of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain
| | - Kerstin Edin
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Montesanti S, Sehgal A, Zaeem L, McManus C, Squires S, Silverstone P. Assessing primary health care provider and organization readiness to address family violence in Alberta, Canada: development of a Delphi consensus readiness tool. BMC PRIMARY CARE 2024; 25:146. [PMID: 38684969 PMCID: PMC11059610 DOI: 10.1186/s12875-024-02396-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta's PHC settings by exploring readiness factors. METHODS An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators. RESULTS Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta. CONCLUSION The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence.
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Affiliation(s)
- Stephanie Montesanti
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | - Anika Sehgal
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lubna Zaeem
- Islamic Family and Social Services Association, Edmonton, AB, Canada
| | - Carrie McManus
- Sagesse Domestic Violence Prevention Society, Calgary, AB, Canada
| | - Suzanne Squires
- Westgrove Clinic, Westview Primary Care Network, Spruce Grove, AB, Canada
| | - Peter Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Fernández Alonso MDC, Salvador Sánchez L, González Bustillo MB, Escribá Agüir V. [The necessary response of health services to gender violence. Comprehensive care and provision of integrated services]. Aten Primaria 2024:S0212-6567(23)00291-3. [PMID: 38272784 DOI: 10.1016/j.aprim.2023.102858] [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: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Gender violence has multiple and serious consequences for the health of victims and their families, hence the reason for the important role that the health system plays in addressing it. Health professionals have a key role in the response, which must include early detection, care, and follow-up; actions in which primary care, because of its privileged position in the system, can play a fundamental part. This article establishes the necessary characteristics for the intervention to be effective: comprehensive care, multidisciplinary approach, intersectoral coordination, and integrated service provision; all of it community-oriented, person-centered, and adapted to its context (social factors and vulnerabilities) with an intersectional approach. The woman, her sons and daughters, and other cohabitants, as well as the perpetrator, are considered the object of intervention in the response, and specific guidelines for action are provided for detection, care, and follow-up. Reorientation of interventions, with emphasis on a community approach, is also proposed.
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Tracy M, Chong LS, Strully K, Gordis E, Cerdá M, Marshall BDL. A Systematic Review of Systems Science Approaches to Understand and Address Domestic and Gender-Based Violence. JOURNAL OF FAMILY VIOLENCE 2023; 38:1-17. [PMID: 37358982 PMCID: PMC10213598 DOI: 10.1007/s10896-023-00578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
Purpose We aimed to synthesize insights from systems science approaches applied to domestic and gender-based violence. Methods We conducted a systematic review of systems science studies (systems thinking, group model-building, agent-based modeling [ABM], system dynamics [SD] modeling, social network analysis [SNA], and network analysis [NA]) applied to domestic or gender-based violence, including victimization, perpetration, prevention, and community responses. We used blinded review to identify papers meeting our inclusion criteria (i.e., peer-reviewed journal article or published book chapter that described a systems science approach to domestic or gender-based violence, broadly defined) and assessed the quality and transparency of each study. Results Our search yielded 1,841 studies, and 74 studies met our inclusion criteria (45 SNA, 12 NA, 8 ABM, and 3 SD). Although research aims varied across study types, the included studies highlighted social network influences on risks for domestic violence, clustering of risk factors and violence experiences, and potential targets for intervention. We assessed the quality of the included studies as moderate, though only a minority adhered to best practices in model development and dissemination, including stakeholder engagement and sharing of model code. Conclusions Systems science approaches for the study of domestic and gender-based violence have shed light on the complex processes that characterize domestic violence and its broader context. Future research in this area should include greater dialogue between different types of systems science approaches, consideration of peer and family influences in the same models, and expanded use of best practices, including continued engagement of community stakeholders. Supplementary Information The online version contains supplementary material available at 10.1007/s10896-023-00578-8.
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Affiliation(s)
- Melissa Tracy
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, 1 University Place, GEC 133, Rensselaer, NY 12144 USA
| | - Li Shen Chong
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
| | - Kate Strully
- Department of Sociology, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
| | - Elana Gordis
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY 12222 USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York, NY 10016 USA
| | - Brandon D. L. Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main St, Providence, RI 02912 USA
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Colombini M, Mayhew SH, García-Moreno C, d'Oliveira AF, Feder G, Bacchus LJ. Improving health system readiness to address violence against women and girls: a conceptual framework. BMC Health Serv Res 2022; 22:1429. [PMID: 36443825 PMCID: PMC9703415 DOI: 10.1186/s12913-022-08826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is an increasing focus on readiness of health systems to respond to survivors of violence against women (VAW), a global human rights violation damaging women's health. Health system readiness focuses on how prepared healthcare systems and institutions, including providers and potential users, are to adopt changes brought about by the integration of VAW care into services. In VAW research, such assessment is often limited to individual provider readiness or facility-level factors that need to be strengthened, with less attention to health system dimensions. The paper presents a framework for health system readiness assessment to improve quality of care for intimate partner violence (IPV), which was tested in Brazil and Palestinian territories (oPT). METHODS Data synthesis of primary data from 43 qualitative interviews with healthcare providers and health managers in Brazil and oPT to explore readiness in health systems. RESULTS The application of the framework showed that it had significant added value in capturing system capabilities - beyond the availability of material and technical capacity - to encompass stakeholder values, confidence, motivation and connection with clients and communities. Our analysis highlighted two missing elements within the initial framework: client and community engagement and gender equality issues. Subsequently, the framework was finalised and organised around three levels of analysis: macro, meso and micro. The micro level highlighted the need to also consider how the system can sustainably involve and interact with clients (women) and communities to ensure and promote readiness for integrating (and participating in) change. Addressing cultural and gender norms around IPV and enhancing support and commitment from health managers was also shown to be necessary for a health system environment that enables the integration of IPV care. CONCLUSION The proposed framework helps identify a) system capabilities and pre-conditions for system readiness; b) system changes required for delivering quality care for IPV; and c) connections between and across system levels and capabilities.
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Affiliation(s)
| | | | - Claudia García-Moreno
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Gene Feder
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
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d’Oliveira AFPL, Pereira S, Bacchus LJ, Feder G, Schraiber LB, de Aguiar JM, Bonin RG, Vieira Graglia CG, Colombini M. Are We Asking Too Much of the Health Sector? Exploring the Readiness of Brazilian Primary Healthcare to Respond to Domestic Violence Against Women. Int J Health Policy Manag 2022; 11:961-972. [PMID: 33327691 PMCID: PMC9808197 DOI: 10.34172/ijhpm.2020.237] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/15/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is growing recognition of the health sector's potential role in addressing domestic violence (DV) against women. Although Brazil has a comprehensive policy framework on violence against women (VAW), implementation has been slow and incomplete in primary healthcare (PHC), and little is known about the implementation challenges. This paper aims to assess the readiness of two PHC clinics in urban Brazil to integrate an intervention to strengthen their DV response. METHODS We conducted 20 semi-structured interviews with health managers and health providers; a document analysis of VAW and DV policies from São Paulo and Brazil; and 2 structured facility observations. Data were analysed using thematic analysis. RESULTS Findings from our readiness assessment revealed gaps in both current policy and practice needing to be addressed, particularly with regards to governance and leadership, health service organisation and health workforce. DV received less political recognition, being perceived as a lower priority compared to other health issues. Lack of clear guidance from the central and municipal levels emerged as a crucial factor that weakened DV policy implementation both by providers and managers. Furthermore, responses to DV lost visibility, as they were diluted within generic violence responses. The organizational structure of the PHC system in São Paulo, which prioritised the number of consultations and household visits as the main performance indicators, was an additional difficulty in legitimising healthcare providers' time to address DV. Individual-level challenges reported by providers included lack of time and knowledge of how to respond, as well as fears of dealing with DV. CONCLUSION Assessing readiness is critical because it helps to evaluate what services and infrastructure are already in place, also identifying obstacles that may hinder adaptation and integration of an intervention to strengthen the response to DV before implementation.
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Affiliation(s)
| | - Stephanie Pereira
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Gene Feder
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lilia Blima Schraiber
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Janaina Marques de Aguiar
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Renata Granusso Bonin
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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García-Quinto M, Briones-Vozmediano E, Otero-García L, Goicolea I, Vives-Cases C. Social workers' perspectives on barriers and facilitators in responding to intimate partner violence in primary health care in Spain. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:102-113. [PMID: 33825247 DOI: 10.1111/hsc.13377] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/03/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To identify the barriers and facilitators of managing intimate partner violence (IPV) cases, from the perspective of primary health care (PHC) social workers. METHOD Qualitative study through interviews with 14 social workers working in PHC centres in Spain. A thematic analysis approach was applied to identify barriers and facilitators according to the Tanahashi model. RESULTS The barriers identified by social workers in providing effective coverage to women suffering from IPV included insufficient practical training, a lack of knowledge from women on social workers' roles, a lack of teamwork, and excess IPV case referrals from other professionals to social workers. The identified facilitators were the existence of electronic protocols and good practices including therapeutic support groups and holistic intervention approaches. CONCLUSIONS An excess of referrals to social workers of identified IPV cases following consultation by other members of the PHC team, alongside the lack of interdisciplinary teamwork, does not enable a comprehensive and holistic approach to this problem. Compulsory, practical, and interdisciplinary training in IPV for all PHC professionals and students must be a priority for health agencies and universities in order to facilitate a comprehensive and quality approach for all women suffering from IPV.
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Affiliation(s)
- Marta García-Quinto
- Public Health Research Group, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Erica Briones-Vozmediano
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Research Group in Society, Health, Education and Culture (GESEC), University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Biomedical Research Institute (IRB), Lleida, Spain
| | - Laura Otero-García
- Department of Nursing, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Isabel Goicolea
- Public Health Research Group, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- Department of Epidemiology and Global Health, Unversity of Umeå, Umeå, Sweden
| | - Carmen Vives-Cases
- Public Health Research Group, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Briones-Vozmediano E, Castellanos-Torres E, Goicolea I, Vives-Cases C. Challenges to Detecting and Addressing Intimate Partner Violence Among Roma Women in Spain: Perspectives of Primary Care Providers. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP10433-NP10452. [PMID: 31524040 DOI: 10.1177/0886260519872299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The objective of this study is to identify challenges and facilitators for detecting and addressing cases of intimate partner violence (IPV) against Roma women, from the perspectives of health personnel and representatives of Roma organizations, and to compare both perspectives. A total of 28 semi-structured interviews were carried out between November 2014 and February 2015 in different Spanish cities. A thematic analysis was carried out, guided by Aday and Andersen's model regarding barriers to access to health services. Both groups signaled the following as principal challenges: (a) consideration of IPV as a private problem among the Roma population, (b) little use of primary care providers for prevention, (c) distrust of Roma women toward primary care professionals as resources for seeking help, (d) the inexistence of Roma professionals in health services, (e) health professionals' lack of cultural sensitivity related to Roma people, and (f) the focus of health protocols for action against IPV on filing a police report. Potential facilitating factors included Roma women's trust in nurses, social workers, and pediatricians and ethnic heterogeneity. There is need to promote action to address the identified challenges through a health equity approach that includes greater training and awareness raising among health professionals about Roma culture and the specific needs of Roma women.
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Affiliation(s)
- E Briones-Vozmediano
- Faculty and Department of Nursing and Physiotherapy, University of Lleida, Spain
- Biomedical Research Institute (IRB), Lleida, Spain
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
| | - E Castellanos-Torres
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
| | - I Goicolea
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - C Vives-Cases
- Public Health Research Group of the University of Alicante, University of Alicante, Spain
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Chavula MP, Svanemyr J, Zulu JM, Sandøy IF. Experiences of teachers and community health workers implementing sexuality and life skills education in youth clubs in Zambia. Glob Public Health 2021; 17:926-940. [PMID: 33661081 DOI: 10.1080/17441692.2021.1893371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zambia, like other low- and middle-income countries, faces numerous adolescent sexual and reproductive health challenges such as teenage pregnancies. This study aimed at understanding teachers' and community health workers' (CHWs) implementation of comprehensive sexuality education (CSE) as part of a comprehensive support package for adolescent girls to prevent early childbearing. Data collected using in-depth interviews [n = 28] with teachers [n = 15] and community health workers [n = 13] were analysed using thematic analysis. The teachers and CHWs reported that the use of participatory approaches and collaboration between them in implementing CSE enabled them to increase girls' and boys' participation youth clubs. However, some teachers and CHWs experienced practical challenges with the manuals because some concepts were difficult to understand and translate into local language. The participants perceived that the youth club increased knowledge on CSE, assertiveness and self-esteem among the learners. Training and providing a detailed teaching manual with participatory approaches for delivering CSE, and collaborative teaching enabled teachers and CHWs to easily communicate sensitive SRH topics to the learners. However, for the adoption of CSE to be even more successful, piloting of the curriculum with local facilitators and translating the manuals into the local languages before they are implemented, is recommended.
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Affiliation(s)
- Malizgani Paul Chavula
- Department of Health Policy and Health Promotion and Education, School of Public Health, University of ZambiaLusaka, Zambia
| | - Joar Svanemyr
- Department of Global Public Health and Primary Care, Center for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, University of Bergen, Bergen, Norway.,Chr. Michelsen Institute, Bergen, Norway
| | - Joseph Mumba Zulu
- Department of Health Policy and Health Promotion and Education, School of Public Health, University of ZambiaLusaka, Zambia
| | - Ingvild Fossgard Sandøy
- Department of Global Public Health and Primary Care, Center for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, University of Bergen, Bergen, Norway
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Szilassy E, Roy J, Williamson E, Pitt K, Man MS, Feder G. Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care. BMC FAMILY PRACTICE 2021; 22:19. [PMID: 33435891 PMCID: PMC7802315 DOI: 10.1186/s12875-020-01297-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 10/25/2020] [Indexed: 12/16/2022]
Abstract
Background Primary care needs to respond effectively to patients experiencing or perpetrating domestic violence and abuse (DVA) and their children, but there is uncertainty about the value of integrated programmes. The aim of the study was to develop and test the feasibility of an integrated primary care system-level training and support intervention, called IRIS+ (Enhanced Identification and Referral to Improve Safety), for all patients affected by DVA. IRIS+ was an adaptation of the original IRIS (Identification and Referral to Improve Safety) model designed to reach female survivors of DVA. Methods Observation of training; pre/post intervention questionnaires with clinicians and patients; data extracted from medical records and DVA agency; semi-structured interviews with clinicians, service providers and referred adults and children. Data collection took place between May 2017 and April 2018. Mixed method analysis was undertaken to triangulate data from various sources to assess the feasibility and acceptability of the intervention. Results Clinicians and service providers believed that the IRIS+ intervention had filled a service gap and was a valuable resource in identifying and referring women, men and children affected by DVA. Despite increased levels of preparedness reported by clinicians after training in managing the complexity of DVA in their practice, the intervention proved to be insufficient to catalyse identification and specialist referral of men and direct identification and referral (without their non-abusive parents) of children and young people. The study also revealed that reports provided to general practice by other agencies are important sources of information about adult and children patients affected by DVA. However, in the absence of guidance about how to use this information in patient care, there are uncertainties and variation in practice. Conclusions The study demonstrates that the IRIS+ intervention is not feasible in the form and timeframe we evaluated. Further adaptation is required to achieve identification and referral of men and children in primary care: an enhanced focus on engagement with men, direct engagement with children, and improved guidance and training on responding to reports of DVA received from other agencies. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-020-01297-5.
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Affiliation(s)
- Eszter Szilassy
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Jessica Roy
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Emma Williamson
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Katherine Pitt
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Mei-See Man
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Gene Feder
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
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Ambikile JS, Leshabari S, Ohnishi M. Knowledge, attitude, and preparedness toward IPV care provision among nurses and midwives in Tanzania. HUMAN RESOURCES FOR HEALTH 2020; 18:56. [PMID: 32746849 PMCID: PMC7398074 DOI: 10.1186/s12960-020-00499-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/23/2020] [Indexed: 05/10/2023]
Abstract
BACKGROUND With increasing recognition of intimate partner violence (IPV) as a public health challenge, nurses and midwives are recognized for their crucial role in providing front-line healthcare services for IPV. This study aimed to evaluate knowledge, attitude, and preparedness related to IPV care provision in health facilities among nurses and midwives in Tanzania. METHODS A self-administered anonymous questionnaire survey was conducted among nurses and midwives working in health facilities in the Mbeya region between December 2018 and January 2019. The questionnaire consisted of questions on their perceived and actual knowledge, attitudes, and preparedness to provide care in relation to IPV. RESULTS A total of 662 (50.1%) of 1321 nurses and midwives who worked in hospitals and/or health centers in the Mbeya region participated in this study, and 461 (69.6%) completed questionnaires were included in the analysis. The proportion of nurses and midwives with high scores in IPV perceived knowledge, actual knowledge, attitude, and preparedness to provide care was 59.9%, 53.1%, 54.2%, and 54.0%, respectively. Regardless of the type of facility, gender, educational level, and work experience, the use of IPV guidelines was significantly associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.004), and preparedness to provide care (P < 0.001), but not attitude, which was negatively associated (P = 0.048). Regardless of the type of facility, gender, educational level, and work experience, receiving preservice IPV training was associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.049), and preparedness to provide care (P = 0.002), but not attitude (P = 0.192). Regardless of the type of facility, gender, educational level, and work experience, in-service IPV training was associated with high scores in IPV perceived knowledge (P < 0.001), actual knowledge (P = 0.043), and preparedness to provide care (P = 0.001), but not attitude (P = 0.063). CONCLUSIONS Although guidelines and training could improve nurses' and midwives' knowledge and preparedness to provide care regarding IPV, attitudes against IPV care are a challenge. To improve attitudes regarding IPV among front-line nurses and midwives, it is necessary to address concepts of IPV care and sympathy with potential and actual victims of IPV in pre- and in-service training in addition to providing recall-level knowledge.
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Affiliation(s)
- Joel Seme Ambikile
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki-ken, 8528520 Japan
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sebalda Leshabari
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mayumi Ohnishi
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki-ken, 8528520 Japan
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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García-Díaz V, Fernández-Feito A, Bringas-Molleda C, Rodríguez-Díaz FJ, Lana A. Tolerance of intimate partner violence and sexist attitudes among health sciences students from three Spanish universities. GACETA SANITARIA 2020; 34:179-185. [DOI: 10.1016/j.gaceta.2019.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 11/26/2022]
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AlJuhani S, AlAteeq M. Intimate partner violence in Saudi Arabia: A topic of growing interest. J Family Med Prim Care 2020; 9:481-484. [PMID: 32318368 PMCID: PMC7113974 DOI: 10.4103/jfmpc.jfmpc_1139_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/22/2020] [Accepted: 01/31/2020] [Indexed: 11/05/2022] Open
Abstract
Intimate partner violence (IPV) is a sensitive, growing, and preventable health issue that affects many people around the world with significant physical and psychological impacts. Factors associated with an increased risk of perpetrating violence include low education, child maltreatment and exposure to violence in the family, attitudes accepting of violence, and gender inequality. However, encounters between victims exposed to IPV and healthcare providers are often not satisfactory, and therefore, several barriers preventing healthcare providers from responding to IPV have been documented. More efforts are needed at different levels to implement preventive measures and to improve the detection and management of IPV victims, especially at front-line health settings like family practices and emergency care services. Several interventions have been suggested to improve the healthcare responses to IPV, including developing protocols, training of health professionals to raise the awareness of providers, transferring know-how, and convincing them to respond to IPV.
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Affiliation(s)
- Sarah AlJuhani
- Department of Family Medicine, College of Medicine, Majmaah University, Majmaah City 11952, Saudi Arabia
| | - Mohammed AlAteeq
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Department of Family Medicine and Primary Health Care, King Abdulaziz Medical City, National Guard - Health Affairs, Riyadh, Saudi Arabia
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