Intimate partner violence as a subject of study during the training of nurses and midwives in Catalonia (Spain): A qualitative study

"Psychological Injuries Are Not Visible": Experiences and Perceptions of Midwives and Nurses about Domestic Violence during Pregnancy

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.

Gender-based violence attitudes and dating violence experiences of students in nursing and other health sciences: A multicentre cross-sectional study

BACKGROUND

Gender-based violence is a major public health problem. Healthcare providers' ability to identify this type of violence and support victims may be influenced by their knowledge, attitudes, and beliefs, which requires solid education.

OBJECTIVES

To identify the gender-based violence attitudes and dating violence experiences of students in nursing and other health sciences.

DESIGN

A multicentre cross-sectional study was performed.

SETTINGS

This study was conducted in three faculties of the University of A Coruña, Spain.

PARTICIPANTS

Participants were undergraduate students of nursing, podiatry, occupational therapy, and physiotherapy.

METHODS

The Attitudes towards Gender and Violence Questionnaire and the Dating Violence Questionnaire were used from October 2019 to March 2020. Descriptive and inferential statistics were calculated to determine associated factors and identify differences in gender-based violence attitudes and dating violence experiences between sexes and degrees.

RESULTS

Data from 459 students were analysed, of whom 180 (39.2 %) studied nursing. The mean age was 20.9 (SD = 3.6) and 76.0 % were women. Statistically significant differences were obtained in attitudes towards gender-based violence according to sex where men displayed more sexist attitudes and violence justification. Results showed a significant difference in attitudes regarding the biological usefulness of sexism and violence between students of nursing and other health sciences. 61.9 % of students had experienced one or more abusive behaviours in relationships; no significant differences were detected according to the degree. However, male students experienced dating violence more often than females. It was observed that students who had suffered dating violence showed greater agreement with sexist attitudes that justify violence.

CONCLUSION

Students of health sciences, particularly males and nursing students, show sexist attitudes that justify gender-based violence. They also frequently experience dating violence, especially psychological violence. It is necessary to intensify or include education on these types of violence in the curricula of degrees in health sciences.

Attention Given to Victims of Gender Violence from the Perspective of Nurses: A Qualitative Study

Women victims of gender violence consider the health system an appropriate place to seek help. Aims and Objectives: to describe and understand how nurses perceive gender-based violence in health care for women victims of gender-based violence. Qualitative descriptive study. The recommendations of the COREQ guide for qualitative research reporting were followed. Sixteen nurses who were working in different health services, both primary and specialized care, were selected to take part in the study. Three focus groups and a semi-structured interview were conducted. The ATLAS.ti 9 computer programme was used. The nurses highlighted that when caring for women who are victims of gender violence, they encounter two types of violence: invisible or latent, and visible or patent. Part of the nurses' role is based on the skill of knowing how to act and being trained to do so. In addition, there are certain controversies around the concept and origin of violence. On the one hand, they refer to gender violence as a universal phenomenon with strong cultural and educational roots, and, on the other hand, it is difficult to characterize. The findings report how nurses play a fundamental role in caring for victims of gender-based violence, but they encounter certain difficulties regarding this concept. It is therefore essential to continuously train and educate nurses on gender-based violence. Gender violence should be a competency in nursing curricula. Health systems must offer training and awareness programmes that teach nurses to detect and make decisions regarding female victims of gender violence. It is also necessary to set up spaces in the different services so that the nurses can attend to the victims.

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.

Analysis in the ethical decision-making of dental, nurse and physiotherapist students, through case-based learning

INTRODUCTION

Training in ethical competencies is perceived with special interest among the objectives of health education. The dimensions of the person such as integrity, autonomy and dignity influence the choice of interventions, but the different specialties of the health sciences conceive these dimensions with different perspectives depending on the clinical setting. These divergences can be detected during the first years of undergraduate studies, and it is important to know the professional bias and its possible causes.

MATERIALS AND METHODS

A procedure was developed through case-based learning (CBL) to assess various characteristics of decision-making during the early stages of student training. A semi-quantitative method was designed based on the narrative responses of a case with ethical implications in the field of gender violence. The method was applied to 294 undergraduate students in nursing (95), physiotherapy (109) and dentistry (90) from the Faculty of Health Sciences of a Spanish university. A frequency analysis of the narrative responses of the students to the proposed case was carried out, using the chi-square test to determine any association between the variables studied: gender, specialty and ethical knowledge.

RESULTS

Four types of response categories were detected, as a result of combining the personal conversation, report to legal authority or require assistance of other teams. The most common option in dentists is conversation only, while physical therapists include the assistance of other teams. In nursing, a balance is observed between both possibilities. The results show that student responses differ significantly among specialties and also differ significantly according to test scores on ethical knowledge. However, no significant differences were found between the responses provided by men and women.

CONCLUSION

Most of the health sciences students highly valued their own capacity for dialogue and reflection to approach situations with complex ethical dimensions. We consider that case-based learning (CBL), in combination with narrative analysis is a valid means of evaluating the professional ethical competencies of students in health sciences careers applied to a common goal.

A qualitative content analysis of nurses' perceptions about readiness to manage intimate partner violence

AIMS

To explore the perceptions of nurses on the factors that influence their readiness to manage intimate partner violence (IPV) in Spain.

DESIGN

Qualitative content analysis based on data from six different regions in Spain (Murcia, Region of Valencia, Castile and Leon, Cantabria, Catalonia, Aragon) collected between 2014 and 2016.

METHODS

37 personal interviews were carried out with nurses from 27 primary health care (PHC) centres and 10 hospitals. We followed the consolidated criteria for reporting qualitative research guidelines. Qualitative content analysis was supported by Atlas.ti and OpenCode.

RESULTS

The results are organised into four categories corresponding to (1) acknowledging IPV as a health issue. An ongoing process; (2) the Spanish healthcare system and PHC service: a favourable space to address IPV although with some limitations; (3) nurses as a key figure for IPV in coordinated care and (4) factors involved in nurses' autonomy in their response to IPV, with their respective subcategories.

CONCLUSION

In practice, nurses perceive responding to IPV as a personal choice, despite the institutional mandate to address IPV as a health issue. There is a need to increase continuous training and ensure IPV is included in the curriculum in university nursing undergraduate degrees, by disseminating the existing IPV protocols. Furthermore, coordination between healthcare professionals needs to be improved in terms of all levels of care and with other institutions.

The impact of violence against women courses on the attitudes of nursing students toward violence against women and their professional roles

This study determines whether the inclusion of violence against women (VAW) education in nursing curricula would improve attitudes and professional help toward victims of violence. Research was carried out as cross-sectional and comparative quasi-experimental study. The research included 524 students; 262 students were trained and 262 were untrained. Data were collected using the Sociodemographic and Personal Charaterics Form, Attitude toward Violence Scale (AVS), and Attitude toward Occupational Roles in Violence Scale (AORVS). The overall average AVS score of students was 30.81 ± 8.68 and overall average AORVS score was 25.50 ± 6.86. There were significant differences in AVS scores and AORVS scores between the experimental and control groups. The scale and sub-dimension mean scores of the students who received the course were significantly lower; it was determined that obtaining low scores reflected divergence from traditionalism and increase in modern opinions in the evaluation of the scales. It is clear that undergraduate courses are an ideal opportunity to initiate changes in attitudes toward intimate partner violence (IPV) and equip graduates with comprehensive knowledge of IPV. This study demonstrates that meeting professional and information needs about VAW by revising nursing curricula is important.

Knowledge, attitude, and preparedness toward IPV care provision among nurses and midwives in Tanzania

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.

Combatting Intimate Partner Violence: Representations of Social and Healthcare Personnel Working with Gender-Based Violence Interventions

Intimate partner violence (IPV) has been declared a global epidemic by the World Health Organization. Although the attention paid to both the perpetrators and victims of gender-based violence has increased, scientific research is still lacking in regard to the representations of operators involved in interventions and management. Therefore, the following study explores how the representations of operators affect how gender violence can be managed and combatted through an ecological approach to this phenomenon, in addition to highlighting the roles of organizational-level services and their cultural and symbolic substrates. In total, 35 health and social professionals were interviewed and textual materials were analyzed by thematic analysis. The evidence suggests that services contrasting gender-based violence utilize different representations and management approaches. The authors hope that these differences can become a resource, rather than a limitation, when combatting gender-based violence through the construction of more integrated networks and a greater dialogue among different services, in order to make interventions designed to combat gender-based violence more effective.

Nurses' knowledge, attitudes and preparedness to manage women with intimate partner violence

AIM

To investigate nurses' knowledge, attitudes and practices related to intimate partner violence among women in Saudi Arabian healthcare settings.

BACKGROUND

There is a global focus on abuse experiences in clinical settings. However, nurses' practice in managing intimate partner violence patients in Saudi healthcare settings has not yet been examined.

INTRODUCTION

Intimate partner violence is a health issue that can lead to mortality and morbidity. It has recently received attention in an Arabian context. Thus, scrutinizing nurses' role in responding to intimate partner violence patients is needed to fill a current gap.

METHODS

A cross-sectional study was conducted with a convenience sample of 114 nurses from two hospitals in Saudi Arabia using a questionnaire.

RESULTS

Minimal previous intimate partner violence training was reported, as 63% of nurses had not received training related to intimate partner violence, and 52% believed that they did not receive adequate training to respond to intimate partner violence survivors. The results show that nurses had both low perceived knowledge and low preparedness in managing intimate partner violence, and only had basic intimate partner violence knowledge. Results indicated that nurses did not have appropriate attitudes towards intimate partner violence. The majority were not aware about intimate partner violence protocols or policies in their institutions. Only 2.6% had diagnosed intimate partner violence in the last six months.

CONCLUSION

There were gaps in nurses' perceived preparedness, knowledge, attitudes and behaviours. There was also limited training and preparation for nurses to assess and address intimate partner violence.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The study suggests the need for clear institutional health policies related to detecting, responding to, and preventing intimate partner violence. Guidelines about integrating intimate partner violence in nursing curricula and implementing in-service training should be developed and implemented. A multi-level intervention that enables nurses to respond to intimate partner violence is also needed.

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.

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

Health care professionals are frequently one of the first points of contact in episodes of intimate partner violence (IPV). This paper presents qualitative data from a larger research project on IPV-related content in undergraduate curriculum for Australian health care professionals. IPV is a serious public health issue with findings from this paper supporting the proposition that key health care workers such as nurses, midwives and paramedics are ill prepared to respond to the challenges it poses.

OBJECTIVE

This study sought to better understand the barriers and facilitators to the inclusion of IPV-related content into undergraduate curricula for nurses, midwives and paramedics.

DESIGN

A multiple-phase, mixed method case study design was the overarching research framework.

SETTING

This is the first national study on the topic in Australia.

PARTICIPANTS AND METHODS

Guided conversations with 18 academics teaching into undergraduate nursing, midwifery and paramedicine courses across Australia.

RESULTS AND CONCLUSIONS

There is a paucity of IPV-related content, with curriculum crowding being a major barrier to its inclusion. Additionally, the qualitative data suggests that IPV is not accepted by academics as being central to the role of a health care professional generally, and nursing more specifically. When contrasted to the emergent needs of those who experience IPV the findings from this study suggest that greater priority should be placed on increasing IPV-related content and academic's capability to teach that content.

Inclusion of intimate partner violence-related content within undergraduate health care professional curriculum: mixed methods study of academics' attitudes and beliefs

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.