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

Health professionals' intervention in the context of domestic violence against women: exploring perceptions and experiences of providing healthcare

Domestic violence against women is a complex social phenomenon and a widely recognised issue of public health, which requires that all sectors of society, including the health sector, take the necessary action to prevent and address it. This paper aims to contribute to the discussion on the role of the primary health care in addressing domestic violence against women, by analysing health professionals' perceptions of their practice as well as the difficulties they experience in providing healthcare to victims. To fulfil this aim, a qualitative approach was chosen, using focus groups with health professionals working in the area of primary health care in an inland region of Portugal. The main findings point to the lack of a specific protocol and insufficient information and skills to respond to domestic violence situations, which hinders health professionals' confidence to intervene and tends to orientate them towards a more medical response. Resulting from these findings, implications for practice are discussed: the need for clear and specific orientations to guide health professionals' intervention; the need to offer training that enables them to provide appropriate healthcare to women experiencing domestic violence; and the need to position themselves in the context of an integrated, multi-sectoral intervention.

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.

The impact of drama education and in-class education on nursing students' attitudes toward violence against women: A randomized controlled study

BACKGROUND

Nurses are the first to intervene in women who were subjected to violence. It is necessary to prepare prospective nurses for this difficult situation in order to enable them to provide quality health services to the victims. Nursing education is of critical importance in gaining nursing students sufficient competencies that they can utilize in intervening in such cases.

OBJECTIVES

This study aims to determine the impact of creative drama education and in-class education on nursing students' attitudes toward violence against women.

DESIGN

This study has a pre-test post-test parallel group randomized controlled design.

SETTING

This study was carried out at a nursing school in Turkey.

PARTICIPANTS

Seventy-eight (n = 78) fourth-year undergraduate nursing science students.

METHOD

In the collection of data, personal information form and İSKEBE Violence Against Women Attitude Scale were used. Data were analyzed using descriptive statistics, Wilcoxon Signed Rank test, and Mann-Whitney U test.

RESULTS

A statistically significant difference was found between the pre-test and post-test scores (Z = -4.911, p = 0.0001) of the experimental group (Z = -5054, p = 0.0001) and the control group. No significant correlation was found between the post-test scores of the experimental and control groups (Effect size = 0.06, Z = -0.525, p = 0.600).

CONCLUSION

It was found that in-class teaching and creative drama were effective in changing the attitude toward violence against women. However, neither method was found to be superior to the other.

A scoping review of the healthcare provided by nurses to people experiencing domestic violence in primary health care settings

Background

Domestic and family violence is a significant and growing public health concern in many communities around the world. Nurses are often the first and sometimes only point of contact for people seeking healthcare following DFV incidents and are therefore well placed to identify and support these vulnerable people. The aim of this scoping review is to examine the English language studies of healthcare provided by nurses in primary healthcare settings to people experiencing domestic and family violence.

Methods

A scoping review of the following databases was undertaken between March-June 2021: CINAHL, Medline, and PubMed. Primary studies were included if written in English, published from 2000 onwards, and focused on the care provided by primary healthcare nurses to people experiencing DFV. A critical appraisal of included studies was conducted using the Mixed Methods Appraisal Tool (MMAT). Results were synthesised narratively.

Results

Six studies were included, from the United States (n = 2), United Kingdom (n = 1), Sweden (n = 2), and Brazil (n = 1). Five studies were quantitative and one qualitative. A fundamental aspect of the healthcare provided by nurses, reported by all studies, was the screening of DFV. Other healthcare provided includes physical and mental health assessment and referral to other services, including sexual assault clinics, social supports, and law enforcement agencies. Findings suggest the level of DFV screening conducted by nurses is limited. Nurses' knowledge of how to support people experiencing DFV was also reportedly limited. Two studies reported that nurses were unfamiliar with DFV practice guidelines and the existence and availability of support networks for people experiencing DFV.

Conclusion

Findings suggest inconsistency in primary healthcare nurses' level of education, skill and knowledge, and detection of people experiencing DFV. As the largest healthcare professional discipline, nurses have frequent contact with people experiencing DFV. There is an urgent need for nurses to be better educationally prepared and more organisationally supported in order to adequately respond and provide healthcare to people experiencing DFV. Given that the number of people experiencing DFV has increased due to the COVID-19 pandemic, it is ever more important for nurses to be well equipped to identify and respond appropriately.

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.

What Matters When Examining Attitudes of Economic Abuse? Gender and Student Status as Predictors of Blaming, Minimizing, and Excusing Economic Abuse

Extensive research has been conducted regarding attitudes toward various types and patterns of violence against intimate partners, but there is a lack of research on attitudes toward economic abuse in general. In the current study, we examined attitudes toward economic abuse by examining how participants blamed the victim, minimized the economic abuse, and excused the perpetrator in hypothetical scenarios. We also examined two characteristics of participants: binary gender differences (i.e., woman, man) and differences between students and non-students. Participants (N = 239) were recruited via the SONA system of a private university (n = 120) and via Amazon's Mechanical Turk (n = 119). Participants were randomly assigned to read one of two hypothetical scenarios to evaluate how scenario condition (i.e., victim employed, victim unemployed), participant gender, and participant student status predicted attitudes toward economic abuse involving blaming, minimizing, and excusing. Moreover, we also examined ambivalent sexism and gender role ideology as predictors. A 2 (scenario condition: job, no job) × 2 (participant gender: woman, man) × 2 (student status: college student, non-college student) MANOVA indicated main effects of both participant gender and participant student status. Follow-up ANOVAs revealed that men were more likely to blame victims, minimize the economic abuse, and excuse perpetrators compared to women. Additionally, students were less likely to minimize the economic abuse compared to non-students. Moreover, both hostile sexism and traditional gender role ideology were significant predictors. Implications of the findings and future directions for researchers are discussed.

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.

Effects of a structured online educational program course on nursing students' attitudes toward gender roles and women and children's violence abuse reports: A quasi-experimental evaluation

BACKGROUND

It is important to know the rights of women and children while shaping attitudes toward gender roles, violence against women, and reporting child abuse. To shape attitudes toward reporting abuse, women's and children's rights courses should be integrated into undergraduate nursing curriculum. It is important to develop positive attitudes of nursing students toward gender roles, violence against women, and reporting child abuse.

OBJECTIVES

The aim of the study was to evaluate the effects of a "women's-children's rights" online-educational program in a nursing curricula.

DESIGN

A pretest-posttest follow-up with a control group quasi-experimental trial.

SETTINGS

Nursing department of the state university in Turkey.

PARTICIPANTS

Fourth-year students (N = 62) of a nursing department at the state university in Turkey constituted the study sample. The students were divided into two groups: education and control groups with each group comprising 31 fourth-year nursing students.

METHODS

The education group took the women's-children's rights online-course, whereas the control group did not. In both groups, baseline assessments were performed online using the "Gender Roles Attitude Scale," "Violence Against Women Attitude Scale," and "Healthcare Provider Attitudes Toward Child Maltreatment Reporting Scale." The posttest (T1) was conducted immediately after the 14-week course was completed. Follow-up was performed after 1 month (T2). Numbers, percentages, chi-square test, t-test, Kolmogorov-Smirnov test, Pearson's correlation, and Duncan's test were conducted using SPSS 20.00 software.

RESULTS

The education group's scores of attitudes toward gender roles, violence against women, and reporting child abuse/neglect were significantly higher than those of the control group (p < 0.05). After the online program, a significant difference between the groups and between the measurements was observed in the education group (p < 0.05).

CONCLUSIONS

The women's-children's rights online-course is an effective method in educating and enriching nursing students on women's and children's rights.

"One of the most important subjects for a healthcare worker": Cross-sectional student evaluation of family violence best practice response curriculum

Family violence can affect the health and well-being of victim-survivors. Nurses and other healthcare providers are well placed to respond to family violence, yet evidence shows that nurses have limited knowledge of family violence and students are unprepared for this work. The objective of this study was to evaluate a pilot of the subject Family Violence Best Practice Response for undergraduate nurses and other healthcare students at an Australian university. The study used a cross-sectional pre-posttest design. Survey instruments included a modified version of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool and the World Health Organization Curriculum evaluation tools. Sixty-four students enrolled in the pilot. Participants made significant improvements in their feelings of preparedness to complete family violence work and in their perceived knowledge across a range of clinical practices and knowledge domains. Qualitative data showed students enjoyed the subject and gained valuable knowledge of how to inquire and validate disclosures. Healthcare professionals should receive training and be ready and able to identify and sensitively respond to victim-survivors of family violence when they enter the workforce.

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.

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.

Nurse Training in Gender-Based Violence Using Simulated Nursing Video Consultations during the COVID-19 Pandemic: A Qualitative Study

Gender-based violence (GBV) is a serious global public health problem that becomes aggravated during public health emergencies that involve quarantine measures. It is important to train nursing students on GBV, especially in vulnerable situations, such as the current COVID-19 pandemic. The purpose of our study is to explore the perceptions of third-year nursing students about simulated nursing video consultations for providing assistance to potential cases of GBV victims using a high-fidelity clinical simulation methodology. After all of the simulated scenarios were completed, 48 scripted interviews were carried out following a guide composed of four open-ended questions to facilitate in-depth discussion. A descriptive qualitative study based on the interpretative paradigm was conducted. The nursing students indicated that they improved their knowledge on GBV victim management (mainly their awareness of the problem, recognition of the role of nursing professionals, and performance of non-technical skills), although they also mentioned the need for continuous training (particularly in socio-emotional skills, interview techniques, a holistic nursing care approach, and not presupposing). This innovative high-fidelity simulation methodology allows nursing students to improve their awareness of the GBV problem, acquire a realistic view about their role in addressing GBV, and build their non-technical skills (such as active listening, communication skills, empathy, and generating confidence) required to adequately care for victims of GBV.