Women's Experiences of Being Screened for Intimate Partner Violence in the Health Care Setting

Intimate partner violence survivors' reported experiences of discrimination in mental health treatment settings

Research indicates that survivors of intimate partner violence (IPV) face substantial stigma and discrimination, with varying impacts based on demographic factors such as race and income. This study explored perceived discrimination among 88 IPV survivors across different racial backgrounds and income levels in mental health settings. Participants completed a mixed-method electronic survey assessing discrimination experiences related to survivor status, income, and race within mental health treatment. Results revealed high levels of perceived discrimination based on survivor status among both racially minoritized and majoritized survivors. However, racially minoritized survivors reported greater racial discrimination and associated stress within mental healthcare settings. Regardless of income level, all survivors reported significant discrimination experiences. Qualitative analysis highlighted factors perceived as helpful or unhelpful within mental health settings. This study underscores the need for further research on socioeconomic influences on stigma experiences among IPV survivors and suggests implications for provider training to better support survivors, especially those from diverse racial backgrounds.

Patient-Centered Intimate Partner Violence Screening, Brief Intervention, and Referral to Treatment

OBJECTIVE

To increase rates of screening for intimate partner violence (IPV), education, and follow-up of women being seen at a private obstetrics and gynecology clinic to 52% in 90 days.

DESIGN

Quality improvement project.

SETTING/LOCAL PROBLEM

IPV screening was not the standard of care at a private suburban obstetric and gynecologic practice.

METHODS

This project used an evidence-backed model for improvement that incorporated plan-do-study-act cycles to implement four core interventions.

INTERVENTIONS

The Hurt, Insult, Threaten, Scream (HITS) screening tool, the investigator-developed Duluth model tool, a case management log, and a team engagement plan were implemented.

RESULTS

Implementation of the HITS screening tool was associated with an increase in IPV screening to 94.7% from a baseline of 2.5%. In addition, the IPV disclosure rate increased 7.5% over the course of the initiative. The majority of staff (64%) participated in IPV educational offerings, and an increase in IPV knowledge was noted in team surveys, on which scores increased from 68% to 76.9%.

CONCLUSION

The combined use of the HITS screening tool and the Duluth model tool were associated with increased rates of IPV screening. Women who screened positive for IPV were referred to appropriate resources. These findings can be used as a guide for clinics to implement IPV screening into practice.

The role of community healthcare professionals in discussing sexual assault experiences during obstetrics and gynecological healthcare appointments

BACKGROUND

Nearly half of adult women in the US report experiencing sexual assault, with almost one-fifth reporting rape. For many sexual assault survivors, healthcare professionals are the first point of contact and disclosure. This study aimed to understand how healthcare professionals working in community settings perceived their role in discussing sexual violence experiences with women during obstetrical and gynecological healthcare appointments. The secondary purpose was to compare healthcare professionals' perspectives with the patients' to determine how sexual violence conversations should occur in these environments.

METHODS

Data were collected in two phases. Phase 1 consisted of 6 focus groups (Sept-Dec, 2019) with women aged 18-45 (n = 22) living in Indiana who sought community-based or private healthcare for women's reproductive healthcare needs. Phase 2 included 20 key-informant interviews with non-physician healthcare professionals (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women's reproductive healthcare. Focus groups and interviews were audio-recorded, transcribed, and analyzed using thematic analyses. HyperRESEARCH assisted in data management and organization.

RESULTS

There were three resulting themes: (1) healthcare professionals' approaches to screening for a history of sexual violence varied depending on how they ask, what setting they work in, and type of professional asking; (2) healthcare experiences can compound traumatic experiences and create distrust with survivors; and (3) sexual violence impacts patient healthcare experiences through what services they seek, how professionals may interact with them, and what professionals they are willing to utilize.

CONCLUSIONS

Findings offered insight into actionable and practical strategies for enhancing sexual violence screening and discussions in community-based women's reproductive health settings. The findings offer strategies to address barriers and facilitators among community healthcare professionals and the people they serve. Incorporating healthcare professional and patient experiences and preferences for violence-related discussions during obstetrical and gynecological healthcare appointments can assist in violence prevention efforts, improve patient-professional rapport, and yield better health outcomes.

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.

Victim-Centered Care Among College Women of Color: A Qualitative Study

AIMS

Women of color are disproportionally affected by intimate partner violence (IPV) and sexual assault (SA), and those on college campuses may have additional risk factors. The purpose of this study was to explore how college-affiliated women of color assign meaning to their interaction with individuals, authorities, and organizations tasked to help survivors of SA and IPV.

METHODS

Semistructured focus group interviews ( N = 87) were transcribed and analyzed using Charmaz's constructivist grounded theory methodology.

RESULTS

Three priority theoretical elements were identified: what hurts , namely, distrust, uncertain outcomes, and silencing of experiences; what helps , namely, support, autonomy, and safety; and desired outcomes , namely, academic progress, supportive social networks, and self-care.

CONCLUSION

Participants were concerned about uncertain outcomes of their interaction with organizations and authorities that are set to help victims. Results can inform forensic nurses and other professionals about the care priorities and needs of college-affiliated women of color in the context of IPV and SA.

Perinatal Care for Individuals With a History of Sexual Trauma

Many women and individuals assigned female at birth experience sexual assault or abuse in their lives leading to sexual trauma. In this article, we review the effects of sexual trauma and resulting chronic stress on the body and during the perinatal period. Maternal, fetal, and neonatal health implications are discussed. Routine screening for sexual assault and violence can assist with early identification and intervention. A variety of modalities and methods for managing the effects of sexual trauma have been identified, including pharmacologic treatment, psychotherapy, complementary and alternative medicine, and shared decision-making. Further research regarding different treatments is essential to find additional tools to aid clinicians providing care to this vulnerable population. When nurses care for individuals with a history of sexual trauma, incorporating trauma-informed care can help prevent retraumatization and promote a healthy perinatal experience.

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.

Women's experiences and expectations of intimate partner abuse identification in healthcare settings: a qualitative evidence synthesis

OBJECTIVES

To explore women's experiences and expectations of intimate partner abuse (IPA) disclosure and identification in healthcare settings, focusing on the process of disclosure/identification rather than the healthcare responses that come afterwards.

DESIGN

Systematic review and meta-synthesis of qualitative studies DATA SOURCES: Relevant studies were sourced by using keywords to search the databases MEDLINE, EMBASE, CINAHL, PsychINFO, SocINDEX and ASSIA in September 2021.

ELIGIBILITY CRITERIA

Studies needed to focus on women's views about IPA disclosure and identification in healthcare settings, use qualitative methods and have been published in the last 5 years.

DATA EXTRACTION AND SYNTHESIS

Relevant data were extracted into a customised template. The Critical Appraisal Skills Programme checklist for qualitative research was used to assess the methodological quality of included studies. A thematic synthesis approach was applied to the data, and confidence in the findings was appraised using The Confidence in the Evidence from Reviews of Qualitative research methods.

RESULTS

Thirty-four studies were included from a range of healthcare settings and countries. Three key themes were generated through analysing their data: (1) Provide universal education, (2) Create a safe and supportive environment for disclosure and (3) It is about how you ask. Included papers were rated overall as being of moderate quality, and moderate-high confidence was placed in the review findings.

CONCLUSIONS

Women in the included studies articulated a desire to routinely receive information about IPA, lending support to a universal education approach that equips all women with an understanding of IPA and options for assistance, regardless of disclosure. Women's suggestions for how to promote an environment conducive to disclosure and how to enquire about IPA have clear implications for clinical practice.PROSPERO registration numberCRD42018091523.

Intimate partner violence in women with breast and gynaecologic cancers: A systematic review

AIM

The current study aimed to systematically review the data obtained from studies on women with breast and gynaecologic cancers subjected to Intimate Partner Violence (IPV).

DESIGN

Systematic review without meta-analysis.

DATA SOURCES

PubMed, ProQuest, Google Scholar, Scopus, Web of Science; databases were searched without time limit.

REVIEW METHOD

The PRISMA model was guided the systematic literature search using Boolean keywords and operators. PICO statement was used to develop a question of this review. Studies examining women with breast and gynaecologic cancers subjected to IPV were included in the study after the quality of the articles was reviewed.

RESULTS

Eight studies that met the inclusion criteria and were conducted between 2000 and 2021 were included in the study.

CONCLUSIONS

Studies confirm the effect of IPV on the severity and consequences of breast and gynaecologic cancers. Having a history of IPV can indirectly lead to breast and gynaecologic cancers. On the other hand, women suffering from IPV are more likely than other women to delay screening or not perform screening for cancer.

IMPACT

The dimensions and nature of violence and the disclosure or non-disclosure of violence in vulnerable women are strongly affected by society's culture. Therefore, researchers need to have sufficient knowledge of the culture and social factors governing the community to achieve reliable findings related to IPV in qualitative, quantitative, and psychometric studies and the design of IPV assessment tools. It is recommended that IPV screening teams, that is, multidisciplinary teams of trained physicians, nurses and social workers, participate in two-way screening programmes: IPV screening for women with gynaecological cancer and screening for gynaecological cancer in women with IPV.

Violencia de género y trastorno de estrés postraumático en mujeres peruanas

Se realizó un estudio descriptivo correlacional de corte transversal, que planteó determinar la asociación entre la violencia de género y el trastorno de estrés postraumático en mujeres peruanas. La muestra estuvo constituida por 105 mujeres que se atendieron en la División de Medicina Legal II de la provincia del Santa (Perú). Para recolección de la información se utilizaron dos instrumentos que fueron sometidos a validez y confiabilidad, la violencia de género se midió mediante un cuestionario constituido por 20 ítems, y el trastorno por estrés postraumático por un cuestionario de 16 ítems. Los resultados evidencian que el 56,2% de mujeres agredidas presentan violencia leve y el 61,9% no presentan síntomas de trastorno de estrés postraumático. Finalmente, se encontró alta asociación significativa entre la violencia de género y los trastornos de estrés postraumático.