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

Educational training programs on intimate partner violence in pregnancy for midwives/student midwives: A scoping review

INTRODUCTION

Educational strategies for preventive screening and effective interventions in midwives are needed to improve clinical practice and outcomes for abused women and their families. This scoping review aimed to describe available educational training programs on intimate partner violence (IPV) in pregnancy for midwives/student midwives.

METHODS

A scoping review of the literature, which was published in English from January 2010 to March 2023, in PUBMED, EBSCO, and CINAHAL databases, was applied. The following keywords were used in the search: 'evaluation', 'educational training', 'course', 'midwives', 'student midwife', 'intimate partner violence', 'pregnancy', combined with AND and OR Boolean operators. The included studies focused on training programs/courses for midwives/student midwives regarding intimate partner violence.

RESULTS

A total of 9 studies were eligible for inclusion, describing six programs for midwives and 3 for student midwives. Educational interventions varied in length (e.g. a few hours to weeks) and educational approaches such as multidisciplinary sessions, lectures, theory, role-playing, practice in screening, group activities, watching videos, and case reports discussion. The programs had similar content, including raising awareness of violence, defining it, discussing gender roles, the impact of IPV on women's health, referral agencies, and the laws regarding violence in each country.

CONCLUSIONS

This scoping review highlighted a lack of educational programs on intimate partner violence during pregnancy, suggesting that new programs need to be developed based on contemporary clinical practices and recommendations for midwifery education.

Perceptions and educational needs of social and healthcare professionals in the prevention of domestic violence - A focus group study

OBJECTIVE

To explore and describe social and healthcare professionals' perceptions and educational needs in relation to domestic violence and its prevention.

METHODS

A qualitative research was conducted in three European countries. Two multidisciplinary focus group interviews were conducted (in each country) among professionals and higher education teachers in the field of social and health care. Total number of participants were 32 (Finland n=12, Greece n=12, Portugal n=8). The transcribed data were analyzed by thematic analysis.

RESULTS

Participants' perceptions of domestic violence and its prevention included: multidimensional phenomenon, consequences, and addressing concern. Domestic violence was seen as a multidimensional phenomenon, which has various consequences for several aspects of life. Professionals have difficulties addressing their concern due to lack of knowledge and tools. Solutions to prevent domestic violence that the participants shared were: education, intervention, and strategies. Education was seen as the key aspect for the prevention of domestic violence. Also, professionals' communication and situation management skills, as well as national and international strategies, were seen as valuable solutions. Educational needs for prevention of domestic violence were expressed based on content, methods, and practices, such as services system and legislation.

CONCLUSION

The findings of the current study highlight the social- and healthcare professionals' need for education about domestic violence. It is essential that these professionals receive appropriate training to effectively identify and address domestic violence. The current study provides useful information for the development of relevant training/education for this group of professionals.

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.

Attitude and preparedness of nursing students in Saudi Arabia concerning the managing of intimate partner violence

AIMS

To assess nursing students' attitudes, professional roles, perceived knowledge and preparedness in managing intimate partner violence.

DESIGN

A cross-sectional descriptive study design was used.

METHODS

The sample consisted of 191 nursing students from 14 universities in Saudi Arabia. Data were collected from November to December 2021 using the Inventory of Beliefs about Intimate Partner Violence, Nursing Roles and Values, Educational Preparedness and Self-Efficacy scales.

RESULTS

The students' attitudes, professional roles, perceived knowledge and preparedness were moderate. When nursing students perceived themselves as knowledgeable, they rejected intimate partner violence, were in favour of their roles in managing intimate partner violence and were confident in their abilities to deal with this issue in practice. Only a quarter of the participants had received education on intimate partner violence although more than half of them were in their fourth year. Female participants had experienced domestic violence/intimate partner violence at a greater rate than male participants. Nursing students who had been exposed to education on intimate partner violence rejected intimate partner violence, but those who experienced domestic violence/intimate partner violence had more tolerant attitudes.

CONCLUSION

This study helps identify potential barriers to preparing nursing students for providing care for victims of intimate partner violence. There is a lack of adequate intimate partner violence educational content in nursing curricula. Establishing effective intimate partner violence education that integrates clinical training in nursing schools is crucial for enhancing students' attitudes and confidence in managing intimate partner violence.

IMPACT

Intimate partner violence (IPV) against women is a major global health problem leading to serious long-term physical and mental health consequences. Nurses have professional roles to fulfil in preventing and managing IPV. Little is known about the attitudes and preparedness of nursing students to manage IPV, especially in the Middle East. Nursing students neither tolerated nor justified IPV and possessed moderate views about the role of nurses in managing it. The students believed that they had adequate knowledge, but their preparedness to manage IPV was lower than their perceived knowledge. A positive and significant relationship was found between IPV education and students' attitudes, although IPV education was not adequately established in undergraduate nursing programs in Saudi Arabia. The prevalence of domestic violence/IPV experiences among the participants was considerable and was higher among female participants. Personally experiencing violence had a significant negative influence on the students' attitudes toward IPV. Nursing curricula should include IPV education that offers training opportunities where the students are able to apply theory in practice. Nursing schools must provide support and consultation for students who are victims or survivors of domestic violence/IPV. Further studies are needed to investigate the effects of IPV on students' attitudes and preparedness for managing it in clinical settings.

A cross-sectional study of Australian chiropractors' and students' readiness to identify and support patients experiencing intimate partner violence

OBJECTIVE

To explore Australian chiropractors' and final year students' readiness to identify and support patient's experiencing intimate partner violence (IPV).

METHODS

This cross-sectional study used the Chiro-PREMIS, an adaptation of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) to explore chiropractors' and final year students' readiness. Survey responses were analyzed through a lens of Miller's framework for developing clinical competence and chiropractic graduate competencies.

RESULTS

One hundred forty participants completed the online survey (n = 99 chiropractors and n = 41 students). Reports of practice over the 4 weeks prior to completing the survey showed 21% of chiropractors and 20% of students consulted with patients who had disclosed they were involved in IPV. Thirty-three percent of chiropractors and 27% of students suspected a patient was involved, but that patient did not disclose. Participants report meager training in IPV. Many are unclear about appropriate questioning techniques, documentation, referrals, identifying available resources, and legal literacy. Overall, participants do not "know" about IPV, they do not "know how" to and may not be able to "show how" or "do" when it comes to managing IPV-related clinical scenarios. Further studies are needed to confirm if chiropractors have the appropriate clinical capabilities.

CONCLUSION

With proper preparation, chiropractors have an opportunity to make a positive contribution to this social problem. We anticipate chiropractic-specific discourse surrounding these escalating growing social concerns will highlight the intent of the chiropractic profession to make a substantial contribution to the health care of the Australian public. More studies are needed.

Effect of Gender Attitudes of Nursing Students on Dating and Domestic Violence Attitudes

Background: Violence and gender inequality duo stand out as a global-scale public health problem, not only because of their frequent prevelances but because of their important effects on youth health. Health workers and especially nurses play an important role in preventing violence Aim: This study aimed to examine the effect of gender attitudes of nursing students on their attitudes towards dating and domestic violence. Methods: This study used a descriptive and cross-sectional design. The sample consisted of a total 638 nursing students. Data were collected with Questionnaire Form, Gender Role Attitude Scale, Dating Violence Attitudes Scale and Domestic Violence Attitude Scale. Mann Whitney U, Kruskall Wallis, correlation analysis, regression analysis, Corrected Bonferroni was used. Results: Students attitudes of social gender roles was found to be high, whereas dating and domestic violence attitudes were found at a medium level. Gender roles attitudes nursing students have an effect on their domestic and dating violence attitudes. Conclusion: While there was a positive direction between gender attitudes and dating violence, there was a negative relationship between domestic violence attitudes.

Nursing students' knowledge, attitudes, preparedness and practice towards intimate partner violence against women: a scoping review and thematic synthesis

BACKGROUND

Nursing students regularly work with women who have experienced intimate partner violence in their clinical placements and subsequently as registered nurses. They have a role in early detection, intervention, onward referral and education of women about intimate partner violence. Therefore, it is necessary to gain a comprehensive understanding of their capability to care for abused women and identify learning needs. Nonetheless, the level of preparedness of nursing students to deal with intimate partner violence has not been reviewed.

AIM

To search and review the existing evidence on nursing students' knowledge, attitudes, preparedness and practice towards intimate partner violence.

METHOD

This scoping review was guided using the PRISMA extension checklist for scoping reviews. Four databases were searched to identify relevant evidence published between 2010 and 2021. The review included eighteen empirical studies (10 quantitative, 4 qualitative and 4 mixed-method studies). Data were extracted and synthesized into seven themes.

RESULT

Nursing students were more knowledgeable of and readily recognized physical and sexual abuse than psychological abuse. Nursing students' roles and attitudes varied widely between different countries. Students faced difficulty in identifying and managing intimate partner violence clinically. Students who received education on domestic violence held more positive attitudes and were more knowledgeable and prepared.

CONCLUSION

Nurse educators need to enhance students' understanding and perception of intimate partner violence and optimize their capability to manage it in the clinical setting. This study identifies barriers to nursing students' readiness to manage intimate partner violence and suggests four areas of development for nursing curricula.

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.

Working with or against the system: Nurses' and midwives' process of providing abortion care in the context of gender-based violence in Australia

AIMS

The aim of this study was to explain the process through which Australian nurses and midwives provide abortion care to people affected by gender-based violence (GBV).

DESIGN

A constructivist grounded theory study.

METHODS

This study took place between 2019 and 2021. The lead author conducted semi-structured interviews with 18 Australian nurses and midwives who provided abortion care. Participants were recruited through pro-abortion, nursing and midwifery networks using a snowballing technique. Data collection and analysis proceeded using purposive and theoretical sampling until we reached data saturation.

FINDINGS

Participants revealed they underwent a process of working with or against the system contingent on the degree to which the system (the interconnected networks through which a pregnant person, victimized by trauma, travels) was woman centred. When participants encountered barriers to person-centred abortion care, they bent or broke the law, local policy and cultural norms to facilitate timely holistic care. Though many participants felt professionally compromised, their resolve to continue working against the system continued.

CONCLUSION

Conservative abortion law, policies and clinical mores did not prevent participants from providing abortion care. The professional obligation to provide person-centred care was a higher priority than following the official or unofficial rules of the organizations.

IMPACT

This study addresses the clinical care of people accessing abortions in the context of GBV. Nurses and midwives may act out against the law, organizational policies and norms if prevented from providing person-centred care. This research is relevant for any location that restricts abortion through stigma, pro-life influences or politics.

Interpersonal Violence: What Undergraduate Nursing Students Know

A program evaluation of undergraduate nursing curricula content was completed and survey developed to assess undergraduate nursing students' knowledge about interpersonal violence. Students electively answered a 43-question survey regarding interpersonal violence as a public health problem. The sample included 104 traditional and accelerated undergraduate nursing students. Increasing scores during undergraduate program enrollment suggests that students receive some content on violence from the undergraduate curriculum. This study provides data about curricular deficits and proposes content revisions to prepare nursing students to address violence in patient populations.