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Allison A, Weerahandi A, Johnson T, Koshan J, Bagstad G, Ferreira C, Jenney A, Krut BA, Wollny K. A Scoping Review on the Use of Experiential Learning in Professional Education on Intimate Partner Violence. JOURNAL OF FAMILY VIOLENCE 2023:1-20. [PMID: 37358988 PMCID: PMC10157572 DOI: 10.1007/s10896-023-00552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 06/28/2023]
Abstract
Purpose Intimate partner violence (IPV) involves any form of emotional, physical, and sexual abuse including controlling behaviors by an intimate partner. Front line service workers such as social workers, nurses, lawyers, and physicians are often the first professionals to come into contact with individuals experiencing IPV but are often inadequately prepared to respond appropriately as IPV education is highly variable. Experiential learning (EL), also known as learning by doing, has gained much attention from educators; however, the extent and type of EL strategies used to teach IPV competencies has not yet been explored. Our aim was to extract what is known from the literature about the use of EL strategies to teach IPV competencies to front line service providers. Methods We conducted a search from May 2021 through November 2021. Reviewers independently screened citations in duplicate using pre-determined eligibility criteria. Data collected included study demographics (publication year, country, etc.), study participants, and information about the IPV EL. Results Of 5216 identified studies, 61 were included. Medicine and nursing represented the majority of learners in the included literature. Graduate students were the targeted learners in 48% of articles. Low fidelity EL was used most frequently in 48% of the articles; and role play was the EL mode most frequently utilized (39%) overall. Conclusions This scoping review provides a comprehensive overview of the limited literature on how EL is used to teach IPV competencies and identifies significant gaps related to the lack of intersectional analysis within educational interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10896-023-00552-4.
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Affiliation(s)
- Aurora Allison
- Faculty of Law, University of Calgary, Calgary, AB Canada
| | - Ambereen Weerahandi
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | - Torri Johnson
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | | | - Georgina Bagstad
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | - Carla Ferreira
- School of Nursing, University of British Columbia, Vancouver, BC Canada
| | - Angelique Jenney
- Faculty of Social Work, University of Calgary, Calgary, AB Canada
| | - Breanne A. Krut
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
| | - Krista Wollny
- Faculty of Nursing, University of Calgary, Drive NW, PF 3239, Calgary, AB T2N 1N4 Canada
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Steen M, Raynor J, Baldwin CD, Jee SH. Child Adversity and Trauma-Informed Care Teaching Interventions: A Systematic Review. Pediatrics 2022; 149:184788. [PMID: 35165742 DOI: 10.1542/peds.2021-051174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Health professionals need training to provide trauma-informed care (TIC) for children with adverse childhood experiences (ACEs), which can affect short- and long-term health. We summarize and evaluate published curricula for health professionals on ACEs and TIC. METHODS We searched PubMed, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, PsychInfo, and MedEdPORTAL through January 2021. Studies meeting the following criteria were included: Described teaching interventions on ACEs, TIC, and child abuse and maltreatment; included health care providers or trainees as learners; were written in English; included an abstract; and described a curriculum and evaluation. We reviewed 2264 abstracts, abstracted data from 79 studies, and selected 51 studies for qualitative synthesis. RESULTS Studies focused on ACEs/TIC (27), child abuse (14), domestic/intimate partner violence (6), and child maltreatment/parental physical punishment (4). Among these 51 studies, 43 were published since 2010. Learners included a mix of health professionals (34) and students (17). Duration, content, and quality of the 51 curricula were highly variable. An analysis of 10 exemplar curricula on ACEs and/or TIC revealed high and very high quality for methods and moderate to very high quality for curriculum evaluation, suggesting that they may be good models for other educational programs. Four of the 10 exemplars used randomized controlled trials to evaluate efficacy. Studies were limited to English language and subject to publication bias. CONCLUSIONS ACEs and TIC are increasingly relevant to teaching health professionals, especially pediatricians, and related teaching curricula offer good examples for other programs.
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Affiliation(s)
| | - Jennifer Raynor
- Edward G. Miner Library, University of Rochester Medical Center, Rochester, New York
| | | | - Sandra H Jee
- Division of General Pediatrics, Department of Pediatrics.,Center for Community Health and Prevention, Rochester, New York
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Ghaith S, Voleti SS, Ginsberg Z, Marks LA, Files JA, Kling JM. A Scoping Review of Published Intimate Partner Violence Curricula for Medical Trainees. J Womens Health (Larchmt) 2022; 31:1596-1613. [PMID: 35231186 DOI: 10.1089/jwh.2021.0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Intimate partner violence (IPV) affects many, and health care has the potential to provide a safe space for individuals experiencing IPV. However, physicians cite lack of time and education as barriers. The aim of this study is to complete a review of published IPV curricula in medical school, residency training, and postresidency training. We performed a scoping review to provide a quantitative assessment and summary review of existing IPV curricula. In May 2020, a librarian conducted a search of Ovid MEDLINE, Ovid EMBASE, and Scopus. We evaluated each article for the following curriculum content and structure items: (1) year introduced; (2) delivery method; (3) curriculum type; (4) curriculum content; (5) curriculum effectiveness; and (6) implementation barriers. Fifty-six articles met criteria, most were for medical school learners (n = 32, 57.1%) and short-term (lasting less than one academic year) (n = 41, 73.2%). For residency, IPV curricula were most frequently taught in family medicine, internal medicine, and emergency medicine. Formal lecture and use of standardized patients were the most popular delivery methods. Most curricula taught risk factors for and identification of individuals who have experienced IPV. The most cited implementation barrier was limited time in standard medical education, followed by inability to measure the effectiveness of the curriculum. There was great variation in the methods of assessing effectiveness of IPV curricula. Published IPV curricula are varied, without consistent validated tools for assessing efficacy. Future initiatives to establish a standard of competency for medical students regarding IPV, including a standard curriculum, may better ensure that physicians are capable of identifying and caring for individuals who have experienced IPV.
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Affiliation(s)
- Summer Ghaith
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Sandeep S Voleti
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Zachary Ginsberg
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Lisa A Marks
- Division of Education, Department of Library Services, Mayo Clinic, Phoenix, Arizona, USA
| | - Julia A Files
- Division of Women's Health Internal Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Phoenix, Arizona, USA
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Beovich B, Williams B. Perceptions of Australian paramedicine students on a novel multi-modal, skills-based intimate partner violence training: A qualitative, exploratory study. NURSE EDUCATION TODAY 2021; 106:105069. [PMID: 34333260 DOI: 10.1016/j.nedt.2021.105069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Intimate partner violence is a global problem with significant adverse sequelae. Healthcare education in this area is limited, and healthcare students and professionals generally lack the confidence to communicate with, and clinically manage patients experiencing intimate partner violence. OBJECTIVES This study aimed to examine the perceptions of undergraduate paramedicine students about intimate partner violence and its management, and intimate partner violence education. DESIGN A qualitative, exploratory study. SETTING An Australian undergraduate paramedicine program. PARTICIPANTS Second- and third-year paramedicine students. METHODS Second-year paramedicine students were provided with intimate partner violence information in the form of relevant literature, a lecture and an online educational package, and a group clinical scenario session. Third-year students were not offered this information or experience. Both 2nd and 3rd year students then participated in a one-on-one clinical scenario with a standardised patient. The students interviewed the patient regarding health concerns, with appropriate questioning eliciting intimate partner violence disclosure. Subsequently, focus groups examined students' views regarding intimate partner violence management and education. Focus group transcripts were thematically analysed. RESULTS Twelve students participated in a standardised patient one-on-one clinical scenario and nine of these students took part in focus groups. Four major themes were identified from the focus groups: i) confidence, ii) uncertainty-what to do now? iii) value of intimate partner violence education, and iv) future of intimate partner violence education. The discourse around lack of confidence appeared to be more pronounced in the students who had not received the intimate partner violence educational package. CONCLUSION The inclusion of a multi-modal intimate partner violence education package, including the utilisation of a standardised patient can be useful in improving paramedicine student confidence to interact with and manage patients impacted by intimate partner violence. Students value this education and are supportive of its incorporation in undergraduate paramedicine programs.
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Affiliation(s)
- Bronwyn Beovich
- Department of Paramedicine, Monash University, Peninsula Campus, Victoria, Australia.
| | - Brett Williams
- Department of Paramedicine, Monash University, Peninsula Campus, Victoria, Australia.
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Mydin FHM, Yuen CW, Othman S. The Effectiveness of Educational Intervention in Improving Primary Health-Care Service Providers' Knowledge, Identification, and Management of Elder Abuse and Neglect: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2021; 22:944-960. [PMID: 31823685 DOI: 10.1177/1524838019889359] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Elder abuse and neglect (EAN) occurrence is expected to increase in many countries due to rapidly aging populations, yet it is still unrecognized and underreported. Gaps were identified in the knowledge and skills to intervene EAN among health-care service providers. It is still unclear whether educating health-care service providers on EAN improve the identification and management of EAN cases. A systematic review was conducted on the effectiveness of educational intervention designed to improve primary health-care service providers' (PHSPs) knowledge, attitude, and practice in managing EAN cases. We performed a comprehensive and systematic search for original studies in the following major electronic databases (ScienceDirect, PubMed, EMBASE, and CINAHL) and specialist registers (Cochrane Central Controlled Trials Register) with a set of search terms. Studies included were randomized controlled trials (RCTs) and observational studies on EAN education intervention that aimed to improve knowledge, attitude, and management skills of the PHSPs. There were no publication period restrictions until June 2018 and written in English. Overall, three RCTs and 10 observational studies were selected. These studies were grouped based on the type of the study, methodological quality (six moderate risk of bias and seven serious risk of bias), and the type of educational intervention (seven face-to-face educational intervention, two educational videos, two simulation-based training, and two online educational training). The education programs in the selected studies range from brief didactic to experiential learning. EAN educational intervention among primary care service providers potentially result in increasing awareness and knowledge on EAN. However, there is a lack of evidence on the changes of attitude and practice.
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Affiliation(s)
- Fadzilah Hanum Mohd Mydin
- Department of Primary Care Medicine, Faculty of Medicine, 37447University of Malaya, and Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Choo Wan Yuen
- Department of Social and Preventive Medicine, Faculty of Medicine, 37447University of Malaya, Kuala Lumpur, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, 37447University of Malaya, and Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia
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West A, Cawley C, Crow E, Stoner AM, Fadel NM, Ford-Scales K, Cheng N. The Impact of an Educational Program on Medical Students' Knowledge and Awareness of Elder Abuse. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211016487. [PMID: 34212112 PMCID: PMC8216339 DOI: 10.1177/23821205211016487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/16/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Approximately 1 in 6 adults 60 and older have experienced a form of abuse in the past year. Many cases remain under-reported due to lack of knowledge and awareness. This study created an educational program on elder abuse for medical students to determine if participation would increase knowledge and awareness of elder abuse. METHODS This study used a pre and post survey methodology to evaluate students' knowledge and awareness of elder abuse before and after participating in this educational program. Sixty first and second year osteopathic medical students at the Edward Via College of Osteopathic Medicine, Carolinas Campus participated in this study. Students were emailed a pre-survey to evaluate their pre-existing knowledge and awareness. The survey was, previously created by the Student Training on Preventing Domestic Violence (STOP-DV) team using validated measures. Participants then attended educational events about various forms of elder abuse and recognizing its associated signs, and afterward completed the post-survey. The results were compared using t-tests to determine if there was a significant difference. RESULTS First and second year students differed significantly in pre-survey results of knowledge but not post-survey results. The results showed a significant difference in overall mean knowledge (P-value < .001) and awareness scores (P-value < .001) in all students. CONCLUSION These results suggest education on elder abuse can enable future physicians to better recognize, understand, and support older adults regarding elder maltreatment.
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Affiliation(s)
- Abbie West
- Edward Via College of Osteopathic Medicine-Carolinas Campus, Spartanburg, SC, USA
| | - Cara Cawley
- Michigan State University/Sparrow Hospital Neurology Program, East Lansing, MI, USA
| | - Elizabeth Crow
- Greenville Prisma Health/University of South Carolina Family Medicine Program, Charleston, SC, USA
| | - Alexis M. Stoner
- Edward Via College of Osteopathic Medicine-Carolinas Campus, Spartanburg, SC, USA
| | - Natalie M. Fadel
- Edward Via College of Osteopathic Medicine-Carolinas Campus, Spartanburg, SC, USA
| | - Kristi Ford-Scales
- Edward Via College of Osteopathic Medicine-Carolinas Campus, Spartanburg, SC, USA
| | - Ning Cheng
- Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL, USA
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Soldatou A, Stathi A, Panos A, Paouri B, Koutsoukou E, Krepis P, Tsolia M, Oral R, Leventhal JM. A national educational campaign to raise awareness of child physical abuse among health care professionals. Eur J Pediatr 2020; 179:1395-1402. [PMID: 32152700 DOI: 10.1007/s00431-020-03625-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 11/29/2022]
Abstract
Education is necessary to improve child physical abuse detection and management. A few studies have described national child abuse training programs, but none has measured changes in knowledge among participants. A collaboration of child abuse experts from the USA, an academic pediatric department, and a non-governmental organization in child protection aimed at (a) training hospital physicians in a train-the-trainer course for the detection and management of child physical abuse and (b) conducting workshops and measuring attendance and gain of knowledge of participants. A train-the-trainer and a national curriculum were created. A 78-item and a 20-item knowledge questionnaire were used pre and post the train-the-trainer course and all workshops, respectively. Nineteen physicians from all pediatric departments of the seven medical schools in Greece attended the course. Eight workshops in seven cities took place with a total attendance of 1220 health care professionals. Gain of knowledge was demonstrated for participants in the train-the-trainer course (p = 0.0015) and local workshops (p < 0.001).Conclusion: We successfully engaged physicians from all medical schools in Greece and conducted a train-the-trainer module and eight workshops in major cities that improved the participants' knowledge in child physical abuse. This approach may help address physician deficiencies in emerging areas of child abuse clinical practice. What is Known: • Education is necessary to improve child physical abuse detection and management. • Although national training programs have been described, none has measured participants' changes in knowledge. What is New: • A collaboration of child abuse experts, all medical schools in Greece, and a non-governmental organization resulted in a national educational campaign in child physical abuse and gains in knowledge for participants. • This approach may help address deficiencies in emerging areas of clinical practice.
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Affiliation(s)
- Alexandra Soldatou
- 2nd Department of Pediatrics, National and Kapodistrian University of Athens, Thivon & Levadeias, Goudi, 11527, Athens, Greece.
| | - Aphrodite Stathi
- ELIZA, Society for the Prevention of Cruelty to Children, Ermou & Christopoulou 2, 10563, Athens, Greece
| | - Alexander Panos
- 2nd Department of Pediatrics, National and Kapodistrian University of Athens, Thivon & Levadeias, Goudi, 11527, Athens, Greece
| | - Bilio Paouri
- 2nd Department of Pediatrics, National and Kapodistrian University of Athens, Thivon & Levadeias, Goudi, 11527, Athens, Greece
| | - Electra Koutsoukou
- ELIZA, Society for the Prevention of Cruelty to Children, Ermou & Christopoulou 2, 10563, Athens, Greece
| | - Panagiotis Krepis
- 2nd Department of Pediatrics, National and Kapodistrian University of Athens, Thivon & Levadeias, Goudi, 11527, Athens, Greece
| | - Maria Tsolia
- 2nd Department of Pediatrics, National and Kapodistrian University of Athens, Thivon & Levadeias, Goudi, 11527, Athens, Greece
| | - Resmiye Oral
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, 03756, USA
| | - John M Leventhal
- Department of Pediatrics, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
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An Ecological Perspective on Elder Abuse Interventions. INTERNATIONAL PERSPECTIVES ON AGING 2020. [DOI: 10.1007/978-3-030-25093-5_14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Nouer SS, Meyer L, Shen Y, Hare ME, Connor PD. Dental students' perceived and actual knowledge of elder abuse: An online training curriculum. SPECIAL CARE IN DENTISTRY 2019; 40:106-112. [PMID: 31867765 DOI: 10.1111/scd.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/25/2019] [Accepted: 11/30/2019] [Indexed: 11/30/2022]
Abstract
AIMS Elder abuse, defined as emotional, physical, or sexual abuse, financial exploitation, or neglect, is a growing problem. Dental professionals have the unique opportunity to identify elder abuse. However, elder abuse awareness training, targeting dental students, is insufficient and research is limited. This knowledge gap prompted the research team at the University of Tennessee Health Science Center (UTHSC) to develop, implement, and evaluate an online Elder Abuse Awareness Professional Education Training (EAAPET) program, designed to educate dental and other health professionals to recognize, respond to, and report elder abuse. METHODS AND RESULTS Ninety-six dental students, attending the UTHSC College of Dentistry during the fall semester of 2018, were enrolled. Pre- and post-assessments, designed to assess changes in students' perceived and actual knowledge, were conducted. Paired sample t-test results indicate that the EAAPET program significantly improved students' perception of their abilities to identify, respond to, and report elder abuse. Improvement was also demonstrated within students' actual knowledge of how to appropriately interact with suspected elder abuse victims. Qualitative assessment suggested the training was well received by the students. CONCLUSIONS Based on these findings, the authors recommend that dental schools integrate elder abuse awareness education into their curriculums.
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Affiliation(s)
- Simonne S Nouer
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Laura Meyer
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Yan Shen
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Marion E Hare
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Pamela D Connor
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
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Healthcare Professionals' Perceptions and Concerns towards Domestic Violence during Pregnancy in Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173087. [PMID: 31450677 PMCID: PMC6747083 DOI: 10.3390/ijerph16173087] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Literature on pregnancy highlighted a large number of women abused by their partners, especially among low-income teenagers attending hospital for pregnancy check-ups. Pregnancy represents a key moment for diagnosing domestic violence. METHOD This study explores health professionals' perceptions and concerns about domestic violence against women in services dealing with pregnant women. The twenty-four interviewees were from an Obstetrical-Gynecological walk-in Clinic in the south of Italy. The textual data has been complementarily analyzed by means of two different procedures: Symbolic-structural semiotic analysis and Thematic content analysis. RESULTS What emerges is that the interviewees of the clinic do not regard the issue of domestic violence as a matter of direct interest for the health service. The clinic is seen as a place for urgent contact, but one where there is not enough time to dedicate to this kind of patient, nor an adequate space to care for and listen to them. Obstetricians and health personnel expressed a negative attitude when it comes to including questions regarding violence and abuse in pre-natal reports. Training for health and social professionals and the empowering of institutional support and networking practices are needed to increase awareness of the phenomenon among the gynecological personnel.
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Divakar U, Nazeha N, Posadzki P, Jarbrink K, Bajpai R, Ho AHY, Campbell J, Feder G, Car J. Digital Education of Health Professionals on the Management of Domestic Violence: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration. J Med Internet Res 2019; 21:e13868. [PMID: 31124462 PMCID: PMC6552406 DOI: 10.2196/13868] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/14/2019] [Accepted: 05/01/2019] [Indexed: 01/10/2023] Open
Abstract
Background The World Health Organization states that 35% of women experience domestic violence at least once during their lifetimes. However, approximately 80% of health professionals have never received any training on management of this major public health concern. Objective The objective of this study was to evaluate the effectiveness of health professions digital education on domestic violence compared to that of traditional ways or no intervention. Methods Seven electronic databases were searched for randomized controlled trials from January 1990 to August 2017. The Cochrane Handbook guideline was followed, and studies reporting the use of digital education interventions to educate health professionals on domestic violence management were included. Results Six studies with 631 participants met our inclusion criteria. Meta-analysis of 5 studies showed that as compared to control conditions, digital education may improve knowledge (510 participants and 5 studies; standardized mean difference [SMD] 0.67, 95% CI 0.38-0.95; I2=59%; low certainty evidence), attitudes (339 participants and 3 studies; SMD 0.67, 95% CI 0.25-1.09; I2=68%; low certainty evidence), and self-efficacy (174 participants and 3 studies; SMD 0.47, 95% CI 0.16-0.77; I2=0%; moderate certainty evidence). Conclusions Evidence of the effectiveness of digital education on health professionals’ understanding of domestic violence is promising. However, the certainty of the evidence is predominantly low and merits further research. Given the opportunity of scaled transformative digital education, both further research and implementation within an evaluative context should be prioritized.
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Affiliation(s)
- Ushashree Divakar
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Nuraini Nazeha
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Pawel Posadzki
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Krister Jarbrink
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Ram Bajpai
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Andy Hau Yan Ho
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.,Psychology Programme, School of Social Sciences, Nanyang Technological University Singapore, Singapore, Singapore.,Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore
| | - James Campbell
- Department of Health Workforce, World Health Organization, Geneva, Switzerland
| | - Gene Feder
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
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Pickering CEZ, Ridenour K, Salaysay Z, Reyes-Gastelum D, Pierce SJ. EATI Island - A virtual-reality-based elder abuse and neglect educational intervention. GERONTOLOGY & GERIATRICS EDUCATION 2018; 39:445-463. [PMID: 27352224 DOI: 10.1080/02701960.2016.1203310] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Despite high prevalence rates of elder abuse and neglect (EA/N), compliance with mandatory reporting remains low. A lack of practical training on EA/N has been identified as a barrier. This article describes the development, implementation, and evaluation of an innovative virtual-reality-based educational intervention intended to improve EA/N recognition and reporting among nurses and social workers providing in-home services. The educational intervention consisted of two parts, including an introductory course and advanced assessment training in virtual reality. The advanced assessment training was focused on learning to use the QualCare Scale, an instrument used to assess quality of family caregiving. Data was evaluated in terms of user satisfaction, changes in knowledge, and changes in practice. Results indicate that participants were satisfied with the content and format of the training program. Participants made gains in knowledge in identification and had 99% accuracy in their mandatory reporting decisions. Importantly, professionals reported making changes in their daily practice based on knowledge and skills learnt. Evaluation data indicate that this interdisciplinary training program was a satisfactory way to learn that produced changes in knowledge and impacted clinical practice. Few implementation barriers were encountered during this project suggesting it would be replicable.
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Affiliation(s)
| | - Kimberly Ridenour
- a College of Nursing , Michigan State University , East Lansing , Michigan USA
| | - Zachary Salaysay
- b School of Nursing , University of Michigan , East Lansing , Michigan USA
| | - David Reyes-Gastelum
- c College of Education , Michigan State University , East Lansing , Michigan USA
| | - Steven J Pierce
- d Center for Statistical Training and Consulting , Michigan State University , East Lansing , Michigan USA
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Zachor H, Chang JC, Zelazny S, Jones KA, Miller E. Training reproductive health providers to talk about intimate partner violence and reproductive coercion: an exploratory study. HEALTH EDUCATION RESEARCH 2018; 33:175-185. [PMID: 29506072 PMCID: PMC6018988 DOI: 10.1093/her/cyy007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/05/2018] [Indexed: 06/08/2023]
Abstract
To explore the effect of provider communication-skills training on frequency of intimate partner violence (IPV) and reproductive coercion (RC) assessment, four family planning clinics were randomized to IPV/RC communication-skills building workshop or standard knowledge-based IPV/RC training and compared to historical controls from the same clinics (before any training). Female patients aged 16-29 completed after-visit surveys. Primary outcomes included provider discussion about IPV/RC, receipt of safety card with IPV/RC resources and patient disclosure of IPV/RC. Chi-square tests were used to compare groups that received training and historical controls. Participants (training: n = 103; historical control: n = 576) were predominantly white with mean age of 22. More patients reported discussion about healthy relationships in both training groups (78-90%) compared to historical controls (49-52%, P < 0.001 for both). Discussion on birth control sabotage and pregnancy coercion was infrequent with patient-participants in both groups (6-17 and 4-13%, respectively). More patients in the clinics that received training reported receiving a safety card (72-84%) as compared to historical controls (9%, P < 0.001 for both). Overall, in this exploratory study, both communication-skills and standard training improved frequency of IPV communication when compared to historical controls but with few differences when compared to each other.
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Affiliation(s)
- H Zachor
- University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, USA
| | - J C Chang
- Department of Obstetrics, Gynecology, and Reproductive Sciences and the Magee-Women’s Research Institute, Department of Medicine, University of Pittsburgh, 3380 Boulevard of the Allies, suite 309, Pittsburgh, PA 15213, USA
| | - S Zelazny
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, 3420 Fifth Ave., Pittsburgh, PA 15213, USA
| | - K A Jones
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, 3420 Fifth Ave., Pittsburgh, PA 15213, USA
| | - E Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, 3420 Fifth Ave., Pittsburgh, PA 15213, USA
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Kong HH, Im S, Seo JH, Kim DK, Roh H. Medical students' clinical performance of dealing with patients in the context of domestic violence. KOREAN JOURNAL OF MEDICAL EDUCATION 2018; 30:31-40. [PMID: 29510606 PMCID: PMC5840562 DOI: 10.3946/kjme.2018.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 11/08/2017] [Accepted: 12/05/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE The aim of this study was to inquire about the clinical performance and determine the performance pattern of medical students in standardized patient (SP) based examinations of domestic violence (DV). METHODS The clinical performance sores in DV station with SP of third-year (n=111, in 2014) and 4th-year (n=143, in 2016) medical students of five universities in the Busan-Gyeongnam Clinical Skills Examination Consortium were subjected in this study. The scenarios and checklists of DV cases were developed by the case development committee of the consortium. The students' performance was compared with other stations encountered in SP. The items of the checklists were categorized to determine the performance pattern of students investigating DV into six domains: disclosure strategy (D), DV related history taking (H), checking the perpetrator's psychosocial state (P), checking the victim's condition (V), negotiating and persuading the interviewee (N), and providing information about DV (I). RESULTS Medical students showed poorer performance in DV stations than in the other stations with SP in the same examination. Most students did confirm the perpetrator and commented on confidentiality but ignored the perpetrator's state and patient's physical and psychological condition. The students performed well in the domains of D, H, and I but performed poorly in domains P, V, and N. CONCLUSION Medical students showed poor clinical performance in the DV station. They performed an 'event oriented interview' rather than 'patient centered' communication. An integrated educational program of DV should be set to improve students' clinical performance.
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Affiliation(s)
- Hyun-Hee Kong
- Department of Parasitology, Dong-A University College of Medicine, Busan, Korea
| | - Sunju Im
- Department of Medical Education, Pusan National University School of Medicine, Busan, Korea
| | - Ji-Hyun Seo
- Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Jinju, Korea
- Department of Medical Education, Gyeongsang National University School of Medicine, Gyeongsang National Institute of Health Sciences, Jinju, Korea
| | - Do-Kyong Kim
- Department of Medical Humanities, Dong-A University College of Medicine, Inje University College of Medicine, Busan, Korea
| | - HyeRin Roh
- Department of Medical Education and the Institute for Medical Humanities, Inje University College of Medicine, Busan, Korea
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Alt KL, Nguyen AL, Meurer LN. The Effectiveness of Educational Programs to Improve Recognition and Reporting of Elder Abuse and Neglect: A Systematic Review of the Literature. J Elder Abuse Negl 2018; 23:213-33. [PMID: 27119527 DOI: 10.1080/08946566.2011.584046] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Health professionals often lack adequate protocols or knowledge to detect, manage, and prevent elder maltreatment. This systematic review describes and evaluates existing literature on the effectiveness of educational interventions to improve health professionals' recognition and reporting of elder abuse and neglect. Fourteen articles described 22 programs ranging from brief didactics to experiential learning and targeted a variety of health and social service audiences. Most evaluations were limited to satisfaction measures. These programs may result in increased awareness, collaboration, and improved case finding. However, using the published literature to guide new program planning is constrained by lack of details and limited evaluations.
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Affiliation(s)
- Kim L Alt
- a Department of Pediatrics , Medical College of Wisconsin , Milwaukee , Wisconsin , USA
| | - Annie L Nguyen
- b Institute for Health and Society , Medical College of Wisconsin , Milwaukee , Wisconsin , USA
| | - Linda N Meurer
- c Department of Family and Community Medicine , Medical College of Wisconsin , Milwaukee , Wisconsin , USA
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Mason R, Wolf M, O'Rinn S, Ene G. Making connections across silos: intimate partner violence, mental health, and substance use. BMC WOMENS HEALTH 2017; 17:29. [PMID: 28403851 PMCID: PMC5389007 DOI: 10.1186/s12905-017-0372-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/03/2017] [Indexed: 11/17/2022]
Abstract
Background Untold numbers of women worldwide are survivors of intimate partner violence (IPV) with a substantial number of these experiencing co-occurring mental health and substance use problems. Despite the complex interconnections among these problems, funding mechanisms and organizational structures and mandates have been designed to address just a single, focal problem. One of the challenges for frontline providers is the lack of effective, evidence-informed inter-professional education or training to help them identify and appropriately respond to co-occurring problems. We developed an evidence-informed, competency-based curriculum to address this gap. In this paper we report on its effectiveness in increasing knowledge, changing beliefs and enhancing skills of frontline workers from all three sectors. Methods The curriculum consists of multiple elements: a text manual; an interactive, online series of modules; and, an in-person workshop. Frontline workers (n = 1111) in the violence against women (VAW) (n = 499), mental health (n = 229), addiction treatment (n = 167), and associated sectors (n = 149) were recruited to attend the workshop and instructed to read the manual or complete the online modules before attending. Some failed to respond (n = 67). Online pre- and post-tests were used to assess changes in knowledge, beliefs and skills; evaluations of the workshop were also collected. Results Matched pre- and post-tests were available for over half of the participants (n = 624). Results show statistically significant improvements across all six competency domains from pre to post-test (p <0.0001). Significant changes in participants’ knowledge and stigmatizing beliefs were achieved. There was no correlation among differences in sector, age, size of organization, years of experience or prior training. Participant feedback made evident prior misconceptions about women experiencing co-occurring problems, improved understanding about the need to bridge silos, as well as the need for enhanced self-care. Conclusions An educational intervention designed to sensitize frontline workers to the realities of women’s experiences of co-occurring problems, educate about the challenges of accessing help when there are co-occurring problems, and bridge discipline and practice-based silos, can effectively challenge and alter providers’ negative attitudes and stigmatizing beliefs. Decreasing stigmatizing beliefs and increasing knowledge has the potential to help survivors access needed help. Electronic supplementary material The online version of this article (doi:10.1186/s12905-017-0372-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Robin Mason
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada. .,Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto, 155 College Street, Toronto, ON, M5T 3 M7, Canada.
| | - Marni Wolf
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada
| | - Susan O'Rinn
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada
| | - Gabrielle Ene
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada
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Turner W, Hester M, Broad J, Szilassy E, Feder G, Drinkwater J, Firth A, Stanley N. Interventions to Improve the Response of Professionals to Children Exposed to Domestic Violence and Abuse: A Systematic Review. CHILD ABUSE REVIEW (CHICHESTER, ENGLAND : 1992) 2017; 26:19-39. [PMID: 28392674 PMCID: PMC5363379 DOI: 10.1002/car.2385] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/15/2014] [Accepted: 02/11/2015] [Indexed: 04/18/2023]
Abstract
Exposure of children to domestic violence and abuse (DVA) is a form of child maltreatment with short- and long-term behavioural and mental health impact. Health care professionals are generally uncertain about how to respond to domestic violence and are particularly unclear about best practice with regards to children's exposure and their role in a multiagency response. In this systematic review, we report educational and structural or whole-system interventions that aim to improve professionals' understanding of, and response to, DVA survivors and their children. We searched 22 bibliographic databases and contacted topic experts for studies reporting quantitative outcomes for any type of intervention aiming to improve professional responses to disclosure of DVA with child involvement. We included interventions for physicians, nurses, social workers and teachers. Twenty-one studies met the inclusion criteria: three randomised controlled trials (RCTs), 18 pre-post intervention surveys. There were 18 training and three system-level interventions. Training interventions generally had positive effects on participants' knowledge, attitudes towards DVA and clinical competence. The results from the RCTs were consistent with the before-after surveys. Results from system-level interventions aimed to change organisational practice and inter-organisational collaboration demonstrates the benefit of coordinating system change in child welfare agencies with primary health care and other organisations. Implications for policy and research are discussed. © 2015 The Authors. Child Abuse Review published by John Wiley & Sons Ltd. 'We searched 22 bibliographic databases and contacted topic experts'. KEY PRACTITIONER MESSAGES We reviewed published evidence on interventions aimed at improving professionals' practice with domestic violence survivors and their children.Training programmes were found to improve participants' knowledge, attitudes and clinical competence up to a year after delivery.Key elements of successful training include interactive discussion, booster sessions and involving specialist domestic violence practitioners.Whole-system approaches aiming to promote coordination and collaboration across agencies appear promising but require funding and high levels of commitment from partners. 'Training programmes were found to improve participants' knowledge, attitudes and clinical competence up to a year after delivery'.
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Affiliation(s)
| | | | | | | | - Gene Feder
- Centre for Academic Primary CareUniversity of BristolUK
| | | | - Adam Firth
- Public Health and Primary CareUniversity of ManchesterUK
| | - Nicky Stanley
- School of Social WorkUniversity of Central LancashirePrestonUK
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Abstract
BACKGROUND Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. OBJECTIVES The objective of this review was to assess the effectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention effects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people. SEARCH METHODS We searched 19 databases (AgeLine, CINAHL, Psycinfo, MEDLINE, Embase, Proquest Central, Social Services Abstracts, ASSIA, Sociological Abstracts, ProQuest Dissertations & Theses Global, Web of Science, LILACS, EPPI, InfoBase, CENTRAL, HMIC, Opengrey and Zetoc) on 12 platforms, including multidisciplinary disciplines covering medical, health, social sciences, social services, legal, finance and education. We also browsed related organisational websites, contacted authors of relevant articles and checked reference lists. Searches of databases were conducted between 30 August 2015 and 16 March 2016 and were not restricted by language. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-randomised trials, and quasi-RCTs, before-and-after studies, and interrupted time series. Only studies with at least 12 weeks of follow-up investigating the effect of interventions in preventing or reducing abuse of elderly people and those who interact with the elderly were included. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the studies' risk of bias. Studies were categorised as: 1) education on elder abuse, 2) programmes to reduce factors influencing elder abuse, 3) specific policies for elder abuse, 4) legislation on elder abuse, 5) programmes to increase detection rate on elder abuse, 6) programmes targeted to victims of elder abuse, and 7) rehabilitation programmes for perpetrators of elder abuse. All studies were assessed for study methodology, intervention type, setting, targeted audience, intervention components and intervention intensity. MAIN RESULTS The search and selection process produced seven eligible studies which included a total of 1924 elderly participants and 740 other people. Four of the above seven categories of interventions were evaluated by included studies that varied in study design. Eligible studies of rehabilitation programmes, specific policies for elder abuse and legislation on elder abuse were not found. All included studies contained a control group, with five of the seven studies describing the method of allocation as randomised. We used the Cochrane 'Risk of bias' tool and EPOC assessment criteria to assess risk of bias. The results suggest that risk of bias across the included body of research was high, with at least 40% of the included studies judged as being at high risk of bias. Only one study was judged as having no domains at high risk of bias, with two studies having two of 11 domains at high risk. One study was judged as being at high risk of bias across eight of 11 domains.All included studies were set in high-income countries, as determined by the World Bank economic classification (USA four, Taiwan one, UK two). None of the studies provided specific information or analysis on equity considerations, including by socio-economic disadvantage, although one study was described as being set in a housing project. One study performed some form of cost-effectiveness analysis on the implementation of their intervention programmes, although there were few details on the components and analysis of the costing.We are uncertain whether these interventions reduce the occurrence or recurrence of elder abuse due to variation in settings, measures and effects reported in the included studies, some of which were very small and at a high risk of bias (low- and very low-quality evidence).Two studies measured the occurrence of elder abuse. A high risk of bias study found a difference in the post-test scores (P value 0.048 and 0.18). In a low risk of bias study there was no difference found (adjusted odds ratio (OR) =0.48, 95% 0.18 to 1.27) (n = 214). For interventions measuring abuse recurrence, one small study (n = 16) reported no difference in post-test means, whilst another found higher levels of abuse reported for the intervention arms (Cox regression, combined intervention hazard ratio (HR) = 1.78, alpha level = 0.01).It is uncertain whether targeted educational interventions improve the relevant knowledge of health professionals and caregivers (very low-quality evidence), although they may improve detection of resident-to-resident abuse. The concept of measuring improvement in detection or reporting as opposed to measuring the occurrence or recurrence of abuse is complicated. An intervention of public education and support services aimed at victims may also improve rates of reporting, however it is unclear whether this was due to an increase in abuse recurrence or better reporting of abuse.The effectiveness of service planning interventions at improving the assessment and documentation of related domains is uncertain. Unintended outcomes were not reported in the studies. AUTHORS' CONCLUSIONS There is inadequate trustworthy evidence to assess the effects of elder abuse interventions on occurrence or recurrence of abuse, although there is some evidence to suggest it may change the combined measure of anxiety and depression of caregivers. There is a need for high-quality trials, including from low- or middle-income countries, with adequate statistical power and appropriate study characteristics to determine whether specific intervention programmes, and which components of these programmes, are effective in preventing or reducing abuse episodes among the elderly. It is uncertain whether the use of educational interventions improves knowledge and attitude of caregivers, and whether such programmes also reduce occurrence of abuse, thus future research is warranted. In addition, all future research should include a component of cost-effectiveness analysis, implementation assessment and equity considerations of the specific interventions under review.
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Affiliation(s)
- Philip RA Baker
- Queensland University of TechnologySchool of Public Health and Social WorkBrisbaneQueenslandAustralia4059
| | - Daniel P Francis
- Queensland University of TechnologySchool of Public Health and Social WorkBrisbaneQueenslandAustralia4059
| | - Noran N Hairi
- University of MalayaDepartment of Social & Preventive Medicine, Faculty of MedicineJalan Lembah PantaiKuala LumpurMalaysia50603
- University of MalayaJulius Centre University of MalayaKuala LumpurMalaysia50603
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia50603
| | - Wan Yuen Choo
- University of MalayaDepartment of Social & Preventive Medicine, Faculty of MedicineJalan Lembah PantaiKuala LumpurMalaysia50603
- University of MalayaJulius Centre University of MalayaKuala LumpurMalaysia50603
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Atkinson HG, Curnin KJ, Hanson NC. U.S. State Laws Addressing Human Trafficking: Education of and Mandatory Reporting by Health Care Providers and Other Professionals. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/23322705.2016.1175885] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jayatilleke AC, Yoshikawa K, Yasuoka J, Poudel KC, Fernando N, Jayatilleke AU, Jimba M. Training Sri Lankan public health midwives on intimate partner violence: a pre- and post-intervention study. BMC Public Health 2015; 15:331. [PMID: 25885635 PMCID: PMC4394591 DOI: 10.1186/s12889-015-1674-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In many developing countries, intimate partner violence (IPV) training is not available for health providers. As a pioneer among developing countries, in 2009, the Sri Lankan Ministry of Health trained a group of community health providers known as public health midwives (PHMs) on IPV. We evaluated that training program's efficacy in improving PHMs' identification and management of IPV sufferers in Kandy, Sri Lanka. METHODS We conducted this study from August 2009 to September 2010. We used a self-administered structured questionnaire to examine the following variables among 408 PHMs: self-reported IPV practices, IPV knowledge, perceived barriers, perceived responsibility, and self-confidence in identifying and assisting IPV sufferers. We used McNemar's test to compare PHMs' pre- and post-intervention IPV practices. Using the Wilcoxon signed-rank test, we compared PHMs' pre-and post-intervention IPV knowledge, as well as their perceived barriers, responsibility, and self-confidence scores. RESULTS The IPV training program improved PHMs' IPV practices significantly. Six months after the intervention, 98.5% (n = 402) of the 408 PHMs identified at least one IPV sufferer in the previous three months, compared to 73.3% (n = 299) in the pre-intervention (p < 0.001). At post-intervention, 96.5% (n = 387) of the PHMs discussed IPV with identified sufferers and suggested solutions; only 67.3% (n = 201) did so at the pre-intervention (p < 0.001). In addition, after the intervention, there were significant increases (p < 0.001) in the median total scores of PHMs' IPV knowledge (0.62 vs. 0.88), perceived responsibility (3.20 vs. 4.60), and self-confidence (1.81 vs. 2.75). PHMs' perceived barriers decreased from 2.43 to 1.14 (p < 0.001). CONCLUSIONS An IPV training program for PHMs improved identification and assistance of IPV sufferers in Kandy, Sri Lanka. This training program has the potential to improve PHMs' skills in preventing IPV and supporting sufferers in other regions of Sri Lanka. Other developing countries might learn lessons from Sri Lanka's IPV training.
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Affiliation(s)
| | - Kayoko Yoshikawa
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Junko Yasuoka
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Krishna C Poudel
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
| | - Nilani Fernando
- Regional Director of Health Services Office, Ministry of Health, Kandy, Sri Lanka.
| | | | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Itimi K, Dienye PO, Gbeneol PK. Intimate Partner Violence and Associated Coping Strategies among Women in a Primary Care Clinic in Port Harcourt, Nigeria. J Family Med Prim Care 2014; 3:193-8. [PMID: 25374852 PMCID: PMC4209670 DOI: 10.4103/2249-4863.141601] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Context: Intimate partner violence (IPV) is an important gender-based, social, and public health problem, affecting women globally. Aims: The aim was to report the prevalence of IPV and describe the coping strategies of the victims. Settings and Design: It was conducted in the general outpatient clinic of a tertiary care hospital using a cross-sectional design. Materials and Methods: A random sample of consenting women living in an intimate partnership for a minimum of 1 year were served with a three part structured questionnaire which sought information on sociodemographic characteristics, the experience of IPV and the Brief COPE Inventory. Statistical Analysis Used: SPSS version 17.0 software, Microsoft word and Excel were used in data handling and analysis. Means, percentages, standard deviations, and Chi-square were calculated. P < 0.05 was considered to be significant. Results: Of the 384 participants, 161 (41.9%) were physically abused. IPV was significantly common among women ≤40 years of age, married couples (78.5%), unemployed and in Christians. It was precipitated by argument with husband (19.25%) and financial demands (44.10%). The employed coping strategy with the highest score was religion. The least score was found in substance abuse. Conclusion: There was significantly high prevalence of domestic violence against women in this study. Hence, routine screening is advocated by family physicians to elicit abuse in order to avoid the more devastating psychological consequences after the incidence so as to institute appropriate treatment as multiple episodes of abuse appears to be cumulative in effect. The reason for violence mainly borders around the argument with husband and finance issues. The coping strategies utilized by the participants minimally involve substance abuse, but more of a religion.
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Affiliation(s)
- Kalamawei Itimi
- Department of Family Medicine, University of Port Harcourt Teaching Hospital, Nigeria
| | - Paul O Dienye
- Department of Family Medicine, University of Port Harcourt Teaching Hospital, Nigeria
| | - Precious K Gbeneol
- Department of Family Medicine, University of Port Harcourt Teaching Hospital, Nigeria
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Ben-Natan M, Sharon I, Barbashov P, Minasyan Y, Hanukayev I, Kajdan D, Klein-Kremer A. Risk factors for child abuse: quantitative correlational design. J Pediatr Nurs 2014; 29:220-7. [PMID: 24263252 DOI: 10.1016/j.pedn.2013.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 10/20/2013] [Accepted: 10/24/2013] [Indexed: 11/26/2022]
Abstract
The aim of this research study is to identify risk factors typical of different types of suspected child abuse reported at a hospital. The study was based on 114 cases of children for whom some type of abuse was reported. Physical abuse was the most frequently reported of all types of suspected child abuse. Most victims of sexual abuse were female and at least half the cases of neglect and physical abuse were attributed to parents. Most cases were identified in the emergency room by nurses. Children older than 10 were more susceptible to physical abuse and neglect.
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Affiliation(s)
- Merav Ben-Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel; Department of Nursing, School of Health Professions, Tel Aviv University, Tel Aviv, Israel.
| | - Ira Sharon
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - Polina Barbashov
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - Yulia Minasyan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - Isabella Hanukayev
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - David Kajdan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - Adi Klein-Kremer
- Head of Pediatric Department, Hillel Yaffe Medical Center, Hadera, Israel
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Choo WY, Hairi NN, Othman S, Francis DP, Baker PRA. Interventions for preventing abuse in the elderly. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sundborg EM, Saleh-Stattin N, Wändell P, Törnkvist L. Nurses' preparedness to care for women exposed to Intimate Partner Violence: a quantitative study in primary health care. BMC Nurs 2012; 11:1. [PMID: 22233776 PMCID: PMC3293728 DOI: 10.1186/1472-6955-11-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 01/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) has a deep impact on women's health. Nurses working in primary health care need to be prepared to identify victims and offer appropriate interventions, since IPV is often seen in primary health care. The aim of the study was to assess nurses' preparedness to identify and provide nursing care to women exposed to IPV who attend primary health care. METHOD Data was collected using a questionnaire to nurses at the primary health care centres. The response rate was 69.3%. Logistic regression analysis was used to test relationships among variables. RESULTS Shortcomings were found regarding preparedness among nurses. They lacked organisational support e.g. guidelines, collaboration with others and knowledge regarding the extensiveness of IPV. Only half of them always asked women about violence and mostly when a woman was physically injured. They felt difficulties to know how to ask and if they identified violence they mostly offered the women a doctor's appointment. Feeling prepared was connected to obtaining knowledge by themselves and also to identifying women exposed to IPV. CONCLUSION The majority of the nurses were found to be quiet unprepared to provide nursing care to women exposed to IPV. Consequences might be treatment of symptoms but unidentified abuse and more and unnecessary suffering for these women. Improvements are needed on both at the level of the organisation and individual.
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Affiliation(s)
- Eva M Sundborg
- Center for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 12, 145 60 Huddinge, Sweden.
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Issenberg SB, Chung HS, Devine LA. Patient Safety Training Simulations Based on Competency Criteria of the Accreditation Council for Graduate Medical Education. ACTA ACUST UNITED AC 2011; 78:842-53. [DOI: 10.1002/msj.20301] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Elliott S, Murrell K, Harper P, Stephens T, Pellowe C. A comprehensive systematic review of the use of simulation in the continuing education and training of qualified medical, nursing and midwifery staff. ACTA ACUST UNITED AC 2011. [DOI: 10.11124/jbisrir-2011-135] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Elliott S, Murrell K, Harper P, Stephens T, Pellowe C. A comprehensive systematic review of the use of simulation in the continuing education and training of qualified medical, nursing and midwifery staff. ACTA ACUST UNITED AC 2011; 9:538-587. [PMID: 27819938 DOI: 10.11124/01938924-201109170-00001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Simulation can be defined as a person, device or set of conditions made to resemble a real life situation. It is used in many high-risk industries particularly when reality is dangerous, critical events are rare and errors are costly in human and/or financial terms. The use of simulation in the UK is now considered an essential component of education programmes designed for healthcare practitioners. However the use of simulation in undergraduate education has been studied in depth but little is known about its use in postgraduate education. OBJECTIVE The aim of this systematic review was to establish: where and in which context is simulation an effective educational medium in post qualifying/continuing education; what is the benefit to learners of using simulation in respect of their knowledge, skills and confidence and what are the implications for future research in this area? INCLUSION CRITERIA This review looked for both quantitative and qualitative evidence in the form of primary research.The review focused on post qualification medical, nursing and midwifery staff undertaking educational development programmes utilising simulation. Types of interventions: the intervention explored in this review is simulation in the form of the re-creation of a patient centred scenario / event in a realistic context. The review explicitly excluded simulation designed to specifically to improve motor skills in isolation from context, such as part task trainers. TYPES OF OUTCOME MEASURES The outcome measures to be explored in this review were: demonstration of the application of knowledge to the simulated clinical situation; demonstrable improvement in knowledge of the environment and equipment; demonstration of risk assessment; safe working practice in relation to the clinical environment; recognition of own limitations and knowing when to call for help; effective communication; team working and leadership skills; evidence from learners in relation to the educational experience; evidence of increased learner confidence following simulated practice; evidence of improved patient outcome being assessed in relation to training SEARCH STRATEGY: The search strategy aimed to find both published and unpublished English language studies from 1998-2009. Databases systematically searched included: Medline, CINAHL, EMBASE, ERIC and the Dissertation Abstracts International Proceedings. METHODOLOGICAL QUALITY Papers were assessed for methodological quality independently by two of the review team. Critical appraisal of methodological quality of papers was undertaken using the Joanna Briggs Institute modules, Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and Qualitative Assessment and Review Instrument (JBI-QARI). Differences in judgment were resolved through discussion between the two reviewers of their differences and through the inclusion of a third reviewer if necessary in order to reach consensus. A fifth member of the team independently reviewed all included and excluded studies as a quality control mechanism. DATA COLLECTION The process of data extraction was undertaken independently by two reviewers using the JBI data extraction tools. DATA SYNTHESIS A statistical meta-analysis of the data was not possible due to the variation in outcome measures used in the papers. The findings are therefore presented descriptively using the specified outcome measures as a reporting framework. RESULTS The initial search identified 1522 papers. Thirty eight papers were considered to have met the inclusion criteria and were subsequently critically appraised for methodological quality. Thirty papers were considered to be of appropriate quality for inclusion in the review. These were predominantly experimental pre post test studies but they covered a wide range of healthcare workers and situations. CONCLUSION There is considerable evidence that suggests that simulation based educational programmes are consistently effective in improving the performance of doctors, nurses and midwives in educational contexts particularly in teamwork and communication. There is also evidence that practitioners value simulation as a learning and teaching strategy. There is however very little evidence to support the assumption that improvements in performance are translated into "real life" clinical settings and ultimately outcomes for service users. IMPLICATIONS FOR PRACTICE Although the evidence base provided by this review is relatively weak in terms of educational practice it would seem to have high face validity. The evidence has added coherence when seen in the context of educational theory and those planning educational programmes for healthcare practitioners should be cognizant of the potential benefits offered by simulation as part of a blended approach to learning. IMPLICATIONS FOR RESEARCH This review has identified a clear need to establish causative links between simulation based educational programmes and improvements in healthcare practice, by using experimental designs where simulation is compared with other educational interventions.
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Affiliation(s)
- Sharon Elliott
- 1. Thames Valley University 2. Barts and The London NHS Trust 3. Thames Valley JBI Center: a Collaborating Center for Joanna Briggs Institute
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Wathen CN, Tanaka M, Catallo C, Lebner AC, Friedman MK, Hanson MD, Freeman C, Jack SM, Jamieson E, MacMillan HL. Are clinicians being prepared to care for abused women? A survey of health professional education in Ontario, Canada. BMC MEDICAL EDUCATION 2009; 9:34. [PMID: 19575776 PMCID: PMC2709616 DOI: 10.1186/1472-6920-9-34] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 06/18/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND The current project undertook a province-wide survey and environmental scan of educational opportunities available to future health care providers on the topic of intimate partner violence (IPV) against women. METHODS A team of experts identified university and college programs in Ontario, Canada as potential providers of IPV education to students in health care professions at the undergraduate and post-graduate levels. A telephone survey with contacts representing these programs was conducted between October 2005 and March 2006. The survey asked whether IPV-specific education was provided to learners, and if so, how and by whom. RESULTS In total, 222 eligible programs in dentistry, medicine, nursing and other allied health professions were surveyed, and 95% (212/222) of programs responded. Of these, 57% reported offering some form of IPV-specific education, with undergraduate nursing (83%) and allied health (82%) programs having the highest rates. Fewer than half of undergraduate medical (43%) and dentistry (46%) programs offered IPV content. Postgraduate programs ranged from no IPV content provision (dentistry) to 41% offering content (nursing). CONCLUSION Significant variability exists across program areas regarding the methods for IPV education, its delivery and evaluation. The results of this project highlight that expectations for an active and consistent response by health care professionals to women experiencing the effects of violence may not match the realities of professional preparation.
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Affiliation(s)
- C Nadine Wathen
- Faculty of Information & Media Studies, The University of Western Ontario, London, Ontario, Canada
| | - Masako Tanaka
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Cristina Catallo
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Adrianne C Lebner
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - M Kinneret Friedman
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mark D Hanson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Clare Freeman
- Interval House of Hamilton-Wentworth, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Ellen Jamieson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Departments of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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