Perinatal violence assessment: teenagers' rationale for denying violence when asked

An integrative review of adolescent trust in the healthcare provider relationship

AIM

To conduct an integrative review of empirical studies examining factors affecting trust in the healthcare provider (HCP) relationship among adolescents.

DESIGN

An integrative review was conducted.

DATA SOURCES

The keywords adolescent, trust, healthcare provider and related words were searched in multiple online research databases. The results were limited to research published between 2004 and 2019. Seventeen primary sources were identified and synthesized in the final review.

REVIEW METHOD

Guided by the Whittemore and Knafl integrative review method, a data-based convergent synthesis design was used to explore the key research question in both qualitative and quantitative research.

RESULTS

This integrative review found that health care provider behaviours, such as confidentiality, honesty, respect, and empathy, promote adolescent's trust of the HCP. Notable gaps in the literature were also identified, including a lack of diversity among adolescent samples and HCP types and underdeveloped measures of adolescent trust of HCP.

CONCLUSION

This integrative review informed the development of a new conceptual definition of adolescent trust of HCP, which embodies the key findings of the importance of HCP confidentiality, honesty, respect, and empathy. This definition can be used to develop instruments, interventions and policies that promote HCP trust among adolescents. Future research is needed to develop instruments to measure adolescents' trust of HCPs, evaluate trust of HCPs among diverse samples of adolescents and evaluate adolescent trust of HCPs with a variety of HCP types.

IMPACT

The new conceptual definition of adolescent trust of HCP can be used to enhance nursing practice and design behavioural interventions to improve trust of HCP. To foster adolescent trust of HCP, policies should be enacted in healthcare institutions to explain confidentiality, provide notification of reporting mandates and formalize consent, assent and dissent for adolescents seeking health care.

Disclosure of Spousal Violence: Viewpoints From the Jordanian Society

The objectives of this study were to identify reasons behind not disclosing spousal violence and examine relationships between these reasons and women's demographic profile including the experience of spousal violence. Jordanian women ( N = 709) aged 16 to 66 years ( M = 32.6, SD = 8.7) attending health care centers were recruited. Results indicated that women's intentions to maintain the family unit and use of patience with abuser represented the top two reasons for not disclosing violence. Non-significant relationships were, generally, identified between not disclosing spousal violence and women's demographic profile. Women's justification of spousal violence and witnessing parental violence were the proposed reasons for women's lack of disclosure of violence. Implications for this study include health professionals' use of evidence-based knowledge and skills to deal with victims of violence. Researchers' roles include creating physical and emotional environment that urges disclosure of violence. Furthermore, they can contribute with health professionals in the implementation of health education programs directing victims and perpetrators in the places where they can be located. Proper collaboration between health professionals, researchers, and policy makers may significantly limit suffering of victims of violence.

Teen Mothers' Experience of Intimate Partner Violence: A Metasynthesis

Pregnant and parenting teens suffer higher rates of intimate partner violence (IPV) than older mothers. This qualitative metasynthesis explores teen mothers' experience with IPV during pregnancy and postpartum. Organized by the metaphor of a web, findings highlight how pervasive violence during childhood contributes to teen pregnancy and the risk of IPV as violence is normalized. The web constricts through the partner's control as violence emerges or worsens with pregnancy. Young mothers become increasingly isolated, and live with the physical and psychological consequences of IPV. Trauma-informed nursing practice is needed to support teen mothers in violent intimate relationships to spin a new web.

Depressive Symptoms and Violence Exposure: Contributors to Repeat Pregnancies Among Adolescents

Depressive symptoms and violence exposure (VE) often cooccur and have been recognized to influence childbearing; contribution to repeat pregnancy is unclear and examined in this article. This cross-sectional, descriptive, study screened for depressive symptoms and VE among 193 adolescent mothers at a large county hospital in Southwestern United States. Repeat pregnancy and depressive symptoms characterized one-third and one-quarter of adolescents, respectively. Despite minimal disclosure of VE, repeat pregnancy was significantly influenced by child abuse and past traumatic life experiences. Assessments and interventions with adolescents should focus on frequency of repeat pregnancies and symptoms of depression and VE. Nurses and childbirth educators are poised to offer birth control information and education, support, and resources highlighting depression and VE to adolescents.

Improving injury prevention through health information technology

Health information technology is an emerging area of focus in clinical medicine with the potential to improve injury and violence prevention practice. With injuries being the leading cause of death for Americans aged 1-44 years, greater implementation of evidence-based preventive services, referral to community resources, and real-time surveillance of emerging threats is needed. Through a review of the literature and capturing of current practice in the field, this paper showcases how health information technology applied to injury and violence prevention can lead to strengthened clinical preventive services, more rigorous measurement of clinical outcomes, and improved injury surveillance, potentially resulting in health improvement.

"It was pretty scary": the theme of fear in young adult women's descriptions of a history of adolescent dating abuse

The mental health impact of abusive adolescent dating relationships has not been well described, but fear related to abuse has been reported. We elaborate the theme of fear in women's descriptions of a history of adolescent dating abuse. A sample of community-based women, ages 19-34, who experienced an abusive dating relationship during adolescence (ages 11-20) was used. Data were analyzed via thematic analysis. Fear was a consistent and resonant theme. Three types of fear were identified: fear for self, fear for other relationships, and fearful expectation. These results offer important insights into the impact of abusive adolescent relationships on women's mental health.

Comparison of screening and referral strategies for exposure to partner violence

BACKGROUND

Although under debate, routine screening for intimate partner violence (IPV) is recommended in health care settings. This study explored the utility of different screening and referral strategies for women exposed to IPV in primary health care.

METHODS

Using a randomized controlled trial design we compared two screening strategies (health care providers [HCP] versus audio computer-assisted self-interviews [A-CASI]) and three referral strategies (HCP alone, A-CASI referral with HCP endorsement, and A-CASI alone). English-speaking women who were 18 years and older and were attending women's health clinics at a public hospital were eligible to participate. Participants were randomly assigned to one of three study groups (HCP screen and referral, A-CASI screen and referral with HCP referral endorsement, and A-CASI screen and referral). Women were reinterviewed by telephone 1 week later. The primary outcome was rate of IPV disclosure; secondary outcomes were screening mode preference, reactions to IPV screening, and use of referral resources.

RESULTS

Of the 129 eligible women, 126 women were enrolled (98%); 102 women (81% of those enrolled) completed the follow-up telephone interview. Disclosure rates were higher for women screened with A-CASI compared with HCP-screened women (21% vs. 9%; p = .07). Screening mode preference, impact of screening (positive and negative reactions), and rates of use of referral resources were similar between study groups.

CONCLUSION

A-CASI tended to yield higher rates of IPV disclosure and similar rates of use of referral resources. A-CASI technology may be a practical way to screen for IPV.

Facilitators and barriers to disclosing abuse among women with disabilities

An anonymous audio computer-assisted self-interview (A-CASI) designed to increase awareness of abuse was completed by 305 women with diverse disabilities. Data were also collected about lifetime and past year abuse; perpetrator risk characteristics; facilitators and barriers to disclosing abuse; abuse disclosure to a health provider, case manager, or police officer; and whether a health provider had ever discussed abuse or personal safety. A total of 276 (90%) women reported abuse, 208 (68%) reported abuse within the past year. Women who reported the most abuse experiences in the past year and the most dangerous perpetrators endorsed fewer facilitators and more barriers, but were also more likely to have ever disclosed abuse. Only 15% reported that a health provider had ever discussed abuse and personal safety.

Breaking the barriers: the promise of computer-assisted screening for intimate partner violence

Although intimate partner violence (IPV) affects hundreds of thousands of women, the majority of women seen in health care settings are not screened for IPV. Many women are hesitant to disclose their abusive situations to their health care providers and, sadly, there is evidence that when women do disclose violence, their health care providers do not give them needed support and information. This article discusses the importance of IPV screening and barriers that may contribute to the current lack of screening by providers and the low disclosure rate by IPV survivors, describes how computer-assisted screening for IPV can address those barriers, and reports the findings of an integrative review of studies about computer-assisted self-interview (CASI) IPV screening. Computer screening strategies consistently identified a higher prevalence of IPV and were the approach preferred by the study participants. The findings of these initial studies provide support for the development and testing of computer screening and intervention strategies for IPV.

Postpartum women's evaluations of an audio/video computer-assisted perinatal violence screen

For universal screening to become a reality, research must first validate the effectiveness and acceptability of violence screening. This study describes postpartum women's perceptions of an anonymous computer-assisted self-interview for perinatal violence screening. A sample of 519 postpartum women completed interviews that included audio and video enhancements. Post-response evaluations were positive with most women, indicating that they preferred computer interviews to face-to-face or written abuse screening. In addition, participants indicated that the computer format and associated anonymity positively influenced their willingness to answer the violence questions truthfully. Computer interviews offer an alternative approach to violence screening that may help women who are hesitant to disclose abuse directly to their healthcare providers.