Qualitative findings from an Australian study of inter-partner violence content within undergraduate health curriculum

Preparedness of Australian and British nurses and midwives about domestic violence and abuse

BACKGROUND

Domestic violence and abuse (DVA) is a major health problem that affects individuals across the world. Nurses, midwives and healthcare providers need to be confident and competent in identifying and responding to DVA.

AIMS

To measure current levels of knowledge, opinions and preparedness towards DVA and how it is managed by registered nurses and midwives residing in Australia and the UK.

METHODS

A cross-sectional study design was used. Data were collected using the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) measuring the perceived preparation and knowledge, actual knowledge, opinions and practice issues. Australian data were collected in 2018 and UK data were collected in 2017-2018. Descriptive and inferential statistics were used to analyse the data and differences in knowledge and attitudes of British and Australian nurses.

FINDINGS

Nurses and midwives (n = 368; 130 from Australia; 238 from the UK) responded to the survey. Minimal previous DVA training was reported by the participants. Participants had minimal knowledge about DVA, though had a positive attitude towards engaging with women experiencing DVA.

DISCUSSION

Most participants felt unprepared to ask relevant questions about DVA and had inadequate knowledge about available resources. Australian participants scored better than British participants; however, the mean difference in all aspects remained statistically insignificant.

CONCLUSION

Australian and British nurses and midwives have a positive attitude towards women experiencing DVA; however, the knowledge and skills to support women experiencing DVA are limited.

IMPLICATIONS FOR NURSING POLICY

Nursing institutions should develop strategic policies regarding mandatory preparation and training of nurses for domestic violence assessment and management.

Curricular Limitations and Recommendations for Training Health Care Providers to Respond to Intimate Partner Violence: An Integrative Literature Review

BACKGROUND

Intimate partner violence (IPV) is a well-known public health problem occurring worldwide. With a multisectoral approach being emphasized in addressing IPV, the health sector has a key role to play due to many IPV victims who appear in health facilities without their needs being met. A well-designed and implemented IPV curriculum is necessary for effectively training health care professionals to provide quality IPV care and related services. This integrative review was conducted to establish evidence for existing curricular limitations and recommendations for training health care providers to respond to IPV.

METHODS

A systematic literature search was conducted for studies published from 2000 to 2020 in five databases (PubMed, Science Direct, Cochrane Library, Google, and Scholar). As a criterion, studies that reported curricular limitations in training health care providers/professionals to address IPV were included. A total of 198 studies were identified for screening, with 16 studies meeting the inclusion criteria and included in the review.

FINDINGS

Curricular limitations for IPV response training for health care providers were reported in the following areas (themes): time allocated for the training, amount of content in the existing curricula, institutional endorsement for the content, IPV response teachers/facilitators, teaching and learning strategies, and funding to support curricular implementation. Various recommendations to improving IPV response training were provided including guaranteeing the training in all courses, increasing academic capability to teach the content, allocation of funding to improve infrastructure for curriculum development and implementation, comprehensive approaches to teaching, and continuing education for health care providers.

The influence of an educational intervention on nursing students' domestic violence knowledge and attitudes: a pre and post intervention study

BACKGROUND

Nurses, as the largest group of health professionals, have a key role in recognising, mitigating and preventing domestic violence. However, studies demonstrating effective undergraduate educational interventions are lacking. The research aim was to compare undergraduate nursing students' knowledge and attitudes about domestic violence before and after an educational intervention on domestic violence and explore their views on the most useful teaching strategies.

METHODS

A quasi-experimental pre and post design was used to determine the impact of an educational intervention. Australian nursing students enrolled in a first-year undergraduate subject were invited to participate. The educational intervention included a 40-min pre-recorded lecture on domestic violence, and a two-hour face-to-face workshop facilitated by an expert, supported by readings. Students completed a pre- and post-intervention online anonymous survey using a validated instrument, the Inventory on Beliefs and Attitudes towards Domestic Violence. Wilcoxon signed rank tests were used to compare pre and post intervention results.

RESULTS

Approximately 400 students completed the voluntary workshop; 198 students completed the pre survey, 176 completed the post survey and 59 (13.1%) completed both. Post intervention, participants indicated stronger agreement on 15 of 22 items. The inventory score became significantly more positive (Z = -3.196, p = .001, CI -.206--0.067) post intervention. Of the 173 students who indicated post intervention which forms of education they found useful, 38.2% considered face-to-face tutorials to be the most useful education modality.

CONCLUSIONS

This study demonstrates the effectiveness of even a small educational intervention in changing attitudes, and creating awareness and knowledge of the context, prevalence, perpetrators, and significant associated burden of illness related to domestic violence, and nurses' responsibility to support victims.

A cross-sectional study of domestic violence instruction in nursing and midwifery programs: Out of step with community and student expectations

BACKGROUND

Domestic violence is a global health concern. Nurses and midwives must respond to those who experience domestic violence, although many are not prepared to do this. The World Health Organization recommend that domestic violence content be included in all pre-registration training as a matter of urgency.

OBJECTIVES

To examine self-reported undergraduate student perceptions of domestic violence content in their programs of study and student attitudes and beliefs about domestic violence.

DESIGN

A cross-sectional research design with online survey was employed from June to October 2017.

METHODS

Using convenience sampling, 1076 students were recruited to the study from a total population sample of just over 6000 undergraduate nursing and midwifery students; a response rate of 17.9%. Survey data reported the nature and frequency of teaching and learning along with student attitudes and beliefs about domestic violence. Open ended responses were examined via thematic analysis.

SETTINGS

Nine Australian universities offering undergraduate nursing and midwifery degrees.

PARTICIPANTS

Undergraduate university nursing and midwifery students.

RESULTS

Over half of students surveyed (53.7%, n = 578) reported that domestic violence was not addressed in their program of study. A direct correlation was found between students' perceived preparedness to assess and respond to domestic violence, and the amount of taught content in their program of study.

CONCLUSION

This major gap in curricula has significant implications for professional practice preparedness. Further research should focus on examining the reasons why quality domestic violence content is lacking in undergraduate nursing and midwifery programs and how prioritisation of domestic violence content can be improved.

Understanding marital violence: a study in grounded theory

Objective:

to understand the phenomenon of marital violence based on the experience of women in judicial process and network professionals.

Method:

a qualitative study, with theoretical-methodological support in grounded theory. Data collection took place in two regional Courts for Peace in the Home in a municipality of the Brazilian Northeast. Interviews were conducted with 38 participants, who composed two sample groups: women in situations of violence and network professionals.

Results:

the understanding of marital violence emerged for the phenomenon “Experiencing marital violence as a progressive and cyclical process, with repercussions for health and implications for social relations”.

Conclusion:

in recognizing marital violence as a recurring problem in the life of women, with implications for their own health and that of their children, the study points to the relevance of coping strategies based on institutional and social support.

Australian nursing and midwifery student beliefs and attitudes about domestic violence: A multi-site, cross-sectional study

Nurses and midwives have a professional responsibility to identify and provide effective care to those experiencing domestic violence. Pre-registration preparation may develop this capability. In order to inform curriculum development, this study explored Australian nursing and midwifery students' attitudes and beliefs about domestic violence. Data were collected between June and October 2017. Descriptive statistics were calculated and comparative analysis performed on independent variables. Thematic analysis was performed on open-ended qualitative responses. Participants included 1076 students from nine Australian universities. The majority were enrolled in nursing programs (88.4%), followed by midwifery (8.6%), and combined nursing/midwifery (2.4%) programs. There was no statistically significant difference in scores by year level across all subscales, suggesting there was no developmental change in beliefs and attitudes toward domestic violence over the course of study. Nursing students held views that were more violence-tolerant than midwifery students. Australian and Chinese-born males were more likely to refute that domestic violence is more common against women. Students had a limited understanding of domestic violence suggesting a critical need to address undergraduate nursing and midwifery curricula.