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Kurbatfinski S, Letourneau N, Luis MA, Conlin J, Holton M, Biletsky R, Hanrieder R, Hansen J, Barber B. The Evaluation of a Domestic Abuse Response Team Program in an Emergency Department. JOURNAL OF FAMILY VIOLENCE 2023:1-14. [PMID: 37358976 PMCID: PMC10144875 DOI: 10.1007/s10896-023-00562-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
Purpose Domestic abuse (e.g., family violence) occurs globally and increases the risk for lifelong adverse health outcomes for all members involved. Although victims of domestic abuse often refrain from seeking support due to various reasons (e.g., fear), health centers such as emergency departments (EDs) can serve as outlets for assistance. The Domestic Abuse Response Team (DART) is a program working collaboratively with a regional hospital center in Alberta, Canada, uniquely providing immediate, expert, and patient-oriented services (e.g., safety plans) to domestic abuse victims within the ED. This study aimed to evaluate the DART program by: (1) using administrative data to characterize ED and DART patient characteristics and (2) examining staff perceptions about DART's operations, effectiveness, challenges, and improvements. Methods A mixed-methods approach was used to collect data from April 1st, 2019 to March 31st, 2020. Quantitative data consisted of descriptive statistics on patient and staff characteristics and qualitative data was collected through two surveys to determine perceptions of the DART program. Results Approximately 60% of ED patients were screened for domestic abuse and 1% were referred to DART, of which 86% were female. All referrals received support within an hour and were provided patient-oriented assistance. Qualitative data revealed that the DART program offers important support to patient victims, increases comfort around dealing with domestic abuse, and decreases ED staff workloads. Conclusions The DART program offers valuable support to domestic abuse victims. Staff reported that DART is effective in providing victims with immediate care and services while also supporting ED staff.
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Affiliation(s)
- Stefan Kurbatfinski
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Community Health Sciences, Cumming School of Medicine University of Calgary, Calgary, Canada
| | - Nicole Letourneau
- Owerko Centre, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
- Community Health Sciences, Cumming School of Medicine University of Calgary, Calgary, Canada
| | | | | | | | | | | | | | - Barbara Barber
- Previously with The Outreach Centre, Red Deer, Canada
- Present Address: Sagesse, Alberta, Canada
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Loncar N, Scott KL. “The Average Counsellor Wouldn’t Know”: Exploring How General Health Practitioners Understand and Respond to Domestic Violence. Can J Nurs Res 2022; 55:153-164. [PMID: 35726162 PMCID: PMC10061613 DOI: 10.1177/08445621221107296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Individuals experiencing and perpetrating intimate partner violence (IPV) are frequently in contact with general health and mental health services. Health service providers, including nurses, thus have a key role in identifying and responding to initial indicators of IPV risk. Purpose The present study provides descriptive information about current assessment and intervention practices of health and mental health service providers when patients are presenting with concerns about IPV. Methods A secondary data analysis of interviews with general health practitioners (n = 17) were coded and dominant themes analyzed through thematic analysis. Results The present study uncovered ways in which IPV-related risks are, and are not, recognized and responded to. A metaphorical visual display in the form of a “domestic violence supply room” depicts the level of access and degree of competency described by practitioners in respective areas of practice. Within reach for all practitioners is the knowledge of factors that increase risk and vulnerability to IPV. Out of reach is a comprehensive understanding of the needs of children and perpetrators as well as the consistent ability to consider intersectionality and be reflexive when working with culturally and linguistically diverse populations. The step ladder to improved IPV response, including formal supports such as training and procedures, is frequently described as lacking. Conclusions A consistent and empirically supported approach to IPV assessment and response is rare to find across generalist service provision. Although service providers possess basic knowledge of risk factors, organizational direction is needed to allow providers to address IPV confidently and effectively.
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Affiliation(s)
- Nicole Loncar
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Katreena L. Scott
- Faculty of Applied Psychology, Centre for Research & Education on Violence Against Women and Children, Western University, London, ON, Canada
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Arora S, Rege S, Bhate-Deosthali P, Thwin SS, Amin A, García-Moreno C, Meyer SR. Knowledge, attitudes and practices of health care providers trained in responding to violence against women: a pre- and post-intervention study. BMC Public Health 2021; 21:1973. [PMID: 34724912 PMCID: PMC8561996 DOI: 10.1186/s12889-021-12042-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Violence against women is a serious public health concern, and is highly prevalent globally, including in India. Health-care providers [HCPs] can play an important role in addressing and reducing negative consequences of violence against women. We implemented a pre-post intervention study of HCP training in three tertiary care facilities in Maharashtra, India. METHODS The study used a pre-post intervention design with assessment of HCPs' (n = 201) knowledge, attitudes, perceived preparedness and practice at three time points: before training, after training and at 6 months follow- up. RESULTS Total median score of knowledge about common signs and symptoms of violence (8.89 vs, 10.00), attitudes towards acceptability of violence (9.05 vs. 10.00), individual (6.74 vs. 10.00) and system level preparedness (6.11 vs. 8.14) improved from pre to post- training. The generalized estimating equation [GEE] model, adjusted for age, sex, site and department, showed an improvement in knowledge, attitudes and preparedness post- training. The change from pre to 6 months follow- up was not significant for attitude. CONCLUSIONS This package of interventions, including training of HCPs, improved HCPs' knowledge, attitudes and practices, yet changes in attitudes and preparedness did not sustain over time. This study indicates feasibility and positive influence of a multi-component intervention to improve HCP readiness to respond to violence against women in a low-resource setting. Future phases of intervention development include adapting this intervention package for primary and secondary health facilities in this context, and future research should assess these interventions using a rigorous experimental design. Finally, these results can be used to advocate for multi-layered, systems-based approaches to strengthening health response to violence against women.
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Affiliation(s)
- Sanjida Arora
- CEHAT - Centre for Enquiry into Health and Allied Themes, Mumbai, India.
| | - Sangeeta Rege
- CEHAT - Centre for Enquiry into Health and Allied Themes, Mumbai, India
| | | | - Soe Soe Thwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Avni Amin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Claudia García-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Sarah R Meyer
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Hughes C, Musselman EA, Walsh L, Mariscal T, Warner S, Hintze A, Rashidi N, Gordon-Murer C, Tanha T, Licudo F, Ng R, Tran J. The mPOWERED Electronic Learning System for Intimate Partner Violence Education: Mixed Methods Usability Study. JMIR Nurs 2020; 3:e15828. [PMID: 34345778 PMCID: PMC8279438 DOI: 10.2196/15828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/01/2019] [Accepted: 11/25/2019] [Indexed: 11/14/2022] Open
Abstract
Background Nurse practitioners are a common resource for victims of intimate partner violence (IPV) presenting to health care settings. However, they often have inadequate knowledge about IPV and lack self-efficacy and confidence to be able to screen for IPV and communicate effectively with patients. Objective The aim of this study was to develop and test the usability of a blended learning system aimed at educating nurse practitioner students on topics related to IPV (ie, the mPOWERED system [Health Equity Institute]). Methods Development of the mPOWERED system involved usability testing with 7 nurse educators (NEs) and 18 nurse practitioner students. Users were asked to complete usability testing using a speak-aloud procedure and then complete a satisfaction and usability questionnaire. Results Overall, the mPOWERED system was deemed to have high usability and was positively evaluated by both NEs and nurse practitioner students. Respondents provided critical feedback that will be used to improve the system. Conclusions By including target end users in the design and evaluation of the mPOWERED system, we have developed a blended IPV learning system that can easily be integrated into health care education. Larger-scale evaluation of the pedagogical impact of this system is underway.
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Affiliation(s)
- Charmayne Hughes
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Elaine A Musselman
- School of Nursing San Francisco State University San Francisco, CA United States
| | - Lilia Walsh
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Tatiana Mariscal
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Sam Warner
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Amy Hintze
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Neela Rashidi
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Chloe Gordon-Murer
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Tiana Tanha
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Fahrial Licudo
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Rachel Ng
- Health Equity Institute San Francisco State University San Francisco, CA United States
| | - Jenna Tran
- Health Equity Institute San Francisco State University San Francisco, CA United States
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Kivelä S, Leppäkoski T, Helminen M, Paavilainen E. Continuation of domestic violence and changes in the assessment of family functioning, health, and social support in Finland. Health Care Women Int 2019; 40:1283-1297. [PMID: 31246155 DOI: 10.1080/07399332.2019.1615917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Our aim in this comparison study was to describe the continuation of domestic violence and to assess changes in the association among family functioning, health, and social support for participants who have or have not experienced violence for the years 2012 and 2015. We collected the data using a family functioning, health, and social support (FAFHES) questionnaire. We collected the baseline questionnaires (N = 188) from patients who visited a Finnish central hospital and mailed the follow-up survey (N = 71). The prevalence of violence remained constant. However, the violence varied and changed. Our findings should encourage health care professionals to better identify and intervene in violence.
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Affiliation(s)
- Salla Kivelä
- Department of Nursing Science, Tampere University, Tampere, Finland
| | - Tuija Leppäkoski
- Department of Nursing Science, Tampere University, Tampere, Finland.,The Hospital District of South Ostrobothnia, Seinäjoki, Finland
| | - Mika Helminen
- Department of Health Sciences, Tampere University, Tampere, Finland.,Research, Development and Innovation Centre, Tampere University Hospital, Tampere, Finland
| | - Eija Paavilainen
- Department of Nursing Science, Tampere University, Tampere, Finland.,The Hospital District of South Ostrobothnia, Seinäjoki, Finland
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McGarry J. Domestic violence and abuse: an exploration and evaluation of a domestic abuse nurse specialist role in acute health care services. J Clin Nurs 2016; 26:2266-2273. [PMID: 27075361 DOI: 10.1111/jocn.13203] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to explore the experiences of clinical staff in responding to disclosure of domestic violence and abuse, and to evaluate the effectiveness of training and support provided by a dedicated Domestic Abuse Nurse Specialist across one acute National Health Service Trust in the UK. BACKGROUND The impact of domestic violence and abuse is well documented and is far reaching. Health care professionals have a key role to play in the effective identification and management of abuse across a range of settings. However, there is a paucity of evidence regarding the constituents of effective support for practitioners within wider nonemergency hospital-based services. DESIGN A qualitative approach semi-structured interviews (n = 11) with clinical staff based in one acute care Trust in the UK. Interviews were informed by an interview guide and analysed using the Framework approach. FINDINGS The organisation of the nurse specialist role facilitated a more cohesive approach to management at an organisational level with training and ongoing support identified as key facets of the role by practitioners. Time constraints were apparent in terms of staff training and this raises questions with regard to the status continuing professional development around domestic violence and abuse. CONCLUSIONS Domestic violence and abuse continues to exert a significant and detrimental impact on the lives and health of those who encounter abuse. Health care services in the UK and globally are increasingly on the frontline in terms of identification and management of domestic violence and abuse. This is coupled with the growing recognition of the need for adequate support structures to be in place to facilitate practitioners in providing effective care for survivors of domestic violence and abuse. RELEVANCE TO CLINICAL PRACTICE This study provides an approach to the expansion of existing models and one which has the potential for further exploration and application in similar settings.
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Affiliation(s)
- Julie McGarry
- School of Health Sciences, A Floor Queens Medical Centre, University of Nottingham, UK
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Leppäkoski TH, Flinck A, Paavilainen E. Greater commitment to the domestic violence training is required. J Interprof Care 2014; 29:281-3. [PMID: 25208090 DOI: 10.3109/13561820.2014.955913] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Domestic violence (DV) is a major public health problem with high health and social costs. A solution to this multi-faceted problem requires that various help providers work together in an effective and optimal manner when dealing with different parties of DV. The objective of our research and development project (2008-2013) was to improve the preparedness of the social and healthcare professionals to manage DV. This article focuses on the evaluation of interprofessional education (IPE) to provide knowledge and skills for identifying and intervening in DV and to improve collaboration among social and health care professionals and other help providers at the local and regional level. The evaluation data were carried out with an internal evaluation. The evaluation data were collected from the participants orally and in the written form. The participants were satisfied with the content of the IPE programme itself and the teaching methods used. Participation in the training sessions could have been more active. Moreover, some of the people who had enrolled for the trainings could not attend all of them. IPE is a valuable way to develop intervening in DV. However, greater commitment to the training is required from not only the participants and their superiors but also from trustees.
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