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Wheatley L, Rosenbaum S, Mastrogiovanni C, Pebole M, Wells R, Rees S, Teasdale S, McKeon G. Readiness of Exercise Physiologists, Physiotherapists and Other Allied Health Professionals to Respond to Gender-Based Violence: A Mixed-Methods Study. Violence Against Women 2024:10778012241257245. [PMID: 38825701 DOI: 10.1177/10778012241257245] [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: 06/04/2024]
Abstract
Experiencing gender-based violence (GBV) is associated with health conditions that are common indications for referral to exercise physiologists, physiotherapists and other allied health professionals (AHPs). The readiness of AHPs to identify and respond to GBV is currently unknown. This study aimed to determine the readiness of AHPs to respond to a person who had experienced GBV. Participants completed the modified Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) and/or an interview. The AHPs felt underprepared, had low perceived knowledge and lacked confidence to respond to and support people who have experienced GBV, despite recognition of the importance and agreement of the relevance to AHPs' practice.
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Affiliation(s)
- Lauren Wheatley
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Chiara Mastrogiovanni
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Michelle Pebole
- The Translational Research Centre for TBI and Stress Disorders, VA Boston Healthcare System, Boston, MA, USA
| | - Ruth Wells
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Susan Rees
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Scott Teasdale
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Mindgardens Neuroscience Network, Sydney, NSW, Australia
| | - Grace McKeon
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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Runyon MC, Copel LC, Trout KK. A concept analysis of psychological trauma in labour and delivery nurses. J Adv Nurs 2024. [PMID: 38762896 DOI: 10.1111/jan.16243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/15/2024] [Accepted: 05/05/2024] [Indexed: 05/21/2024]
Abstract
AIM To facilitate an understanding of the risk for psychological trauma in labour and delivery nurses. DESIGN Concept analysis. METHODS The Walker and Avant method of concept analysis was applied to 56 articles. The characteristics, antecedents, and consequences of psychological trauma in labour and delivery nurses were identified. DATA SOURCES Peer-reviewed articles in English from CINAHL, PubMed and Google Scholar were reviewed on July 2023. RESULTS The characteristics of psychological trauma in labour and delivery nurses are overwhelming distress, intrusive symptoms, avoidance and numbing behaviours, hypervigilance or hyperarousal, emotional dysregulation, cognitive distortions, and interpersonal challenges. The antecedents are exposure to one or more of the following nurse-specific traumas: natural or person-made disasters, historical role limitations, second victim situations, secondary trauma, system-mediated or over-medicalized care, insufficient resources, or workplace incivility. The consequences are disruptions in mental health, diminished physical health, alterations in relationships, and variable work performance. CONCLUSION Labour and delivery nurses experience unique causes of psychological trauma due to their practice environment and patient population. The consequences of labour and delivery nurses' psychological trauma extend beyond individual health and impact the quality of patient care and organizational capacity. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Furthermore, research is needed to inform education, support and policy measures to mitigate harm effectively. WHAT PROBLEM DID THE STUDY ADDRESS?: Nurse-specific trauma theory has not been applied to the unique labour and delivery environment with a high incidence of patient trauma. WHAT WERE THE MAIN FINDINGS?: Multiple causes of trauma in the perinatal context have created a pervasive yet largely preventable issue. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This research will impact labour and delivery nurses, their leadership, and their patients. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Maggie C Runyon
- Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Linda Carman Copel
- Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Kimberly K Trout
- Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
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Keynejad RC, Boardman-Pretty T, Barber S, Tweed J, Forshall E, Edwards A, Shotton J, Wilson CA. Detection of and response to gender-based violence: a quality improvement project across three secondary mental health services in London. BJPsych Bull 2024:1-6. [PMID: 38639203 DOI: 10.1192/bjb.2024.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
AIMS AND METHOD Our team of core and higher psychiatry trainees aimed to improve secondary mental health service detection of and response to gender-based violence (GBV) in South East London. We audited home treatment team (HTT), drug and alcohol (D&A) service and in-patient ward clinical records (n = 90) for female and non-binary patients. We implemented brief, cost-neutral staff engagement and education interventions at service, borough and trust levels before re-auditing (n = 86), completing a plan-do-study-act cycle. RESULTS Documented enquiry about exposure to GBV increased by 30% (HTT), 15% (ward) and 7% (D&A), post-intervention. We identified staff training needs and support for improving GBV care. Up to 56% of records identified psychiatric symptoms related to GBV exposure. CLINICAL IMPLICATIONS Moves to make mental healthcare more trauma-informed rely on services first being supportive environments for enquiry, disclosure and response to traumatic stressors. Our collaborative approach across clinical services increased GBV enquiry and documentation. The quality of response is more difficult to measure and requires concerted attention.
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Affiliation(s)
- Roxanne C Keynejad
- King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Sarah Barber
- King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - John Tweed
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Emily Forshall
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Alice Edwards
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Joshua Shotton
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Claire A Wilson
- King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Kurt G, Akın A. Gender and exposure to childhood violence are important determinants of domestic violence among academics. Heliyon 2023; 9:e22078. [PMID: 38034745 PMCID: PMC10682135 DOI: 10.1016/j.heliyon.2023.e22078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023] Open
Abstract
Domestic violence is a common and significant social problem that threatens public health, violates human rights, and poses significant obstacles to national development. This study aimed to evaluate both male and female academics' knowledge and views on domestic violence, and determine its incidence and risk factors among academics. Participants comprised 304 academics working at universities, who were selected by cluster sampling from seven regions of Turkey. Data were analyzed using thematic coding, descriptive statistics, and multivariate logistic regression. Of the 304 participants, 56.9 % were female academics. The incidence of domestic violence among the academics was 21.4 %, with 25.4 % of female and 16.0 % of male academics reporting having experienced it. Academics who were victims of domestic violence were mostly exposed to it from their spouses. Academics also reported experiencing emotional violence. Female academics were 2.3 times more likely to experience domestic violence than men. Academics who were exposed to violence in childhood experienced 14.1 times more domestic violence than those who were not. Although it seems that a high status in society as an academic reduces the rates of exposure to domestic violence, gender, and witnessing or experiencing violence in early childhood are the most important risk factors for this population. The lack of a solution for domestic violence can be attributed to non-deterrent punishments.
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Affiliation(s)
- Gonca Kurt
- Department of Health Care Services, Pazar Vocational School of Higher Education, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Ayşe Akın
- Department of Public Health, School of Medicine Department of Internal Medicine, Başkent University, Ankara, Turkey
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Emsley E, Szilassy E, Dowrick A, Dixon S, De Simoni A, Downes L, Johnson M, Feder G, Griffiths C, Panovska-Griffiths J, Barbosa EC, Wileman V. Adapting domestic abuse training to remote delivery during the COVID-19 pandemic: a qualitative study of views from general practice and support services. Br J Gen Pract 2023; 73:e519-e527. [PMID: 37308305 PMCID: PMC10285687 DOI: 10.3399/bjgp.2022.0570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/24/2023] [Accepted: 04/21/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Identifying and responding to patients affected by domestic violence and abuse (DVA) is vital in primary care. There may have been a rise in the reporting of DVA cases during the COVID-19 pandemic and associated lockdown measures. Concurrently general practice adopted remote working that extended to training and education. IRIS (Identification and Referral to Improve Safety) is an example of an evidence-based UK healthcare training support and referral programme, focusing on DVA. IRIS transitioned to remote delivery during the pandemic. AIM To understand the adaptations and impact of remote DVA training in IRIS-trained general practices by exploring perspectives of those delivering and receiving training. DESIGN AND SETTING Qualitative interviews and observation of remote training of general practice teams in England were undertaken. METHOD Semi-structured interviews were conducted with 21 participants (three practice managers, three reception and administrative staff, eight general practice clinicians, and seven specialist DVA staff), alongside observation of eight remote training sessions. Analysis was conducted using a framework approach. RESULTS Remote DVA training in UK general practice widened access to learners. However, it may have reduced learner engagement compared with face-to-face training and may challenge safeguarding of remote learners who are domestic abuse survivors. DVA training is integral to the partnership between general practice and specialist DVA services, and reduced engagement risks weakening this partnership. CONCLUSION The authors recommend a hybrid DVA training model for general practice, including remote information delivery alongside a structured face-to-face element. This has broader relevance for other specialist services providing training and education in primary care.
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Affiliation(s)
| | | | - Anna Dowrick
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Sharon Dixon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
| | - Anna De Simoni
- Wolfson Institute of Population Health, Queen Mary University of London, London
| | - Lucy Downes
- Identification and Referral to Improve Safety network director
| | - Medina Johnson
- Identification and Referral to Improve Safety interventions, Bristol
| | - Gene Feder
- Bristol Medical School, University of Bristol, Bristol
| | - Chris Griffiths
- Wolfson Institute of Population Health, Queen Mary University of London, London
| | | | | | - Vari Wileman
- School of Mental Health and Psychological Sciences, Institute of Psychiatry and Neuroscience, King's College London, London
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Keynejad RC. Domestic violence and mental health during
COVID
‐19. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2023. [DOI: 10.1002/pnp.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Roxanne C Keynejad
- Dr Keynejad is an ST5 Higher Trainee in General Adult Psychiatry at South London and Maudsley NHS Foundation Trust
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Have you experienced domestic abuse? Br Dent J 2022. [DOI: 10.1038/s41415-022-5241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Emsley E, Smith J, Martin D, Lewis NV. Trauma-informed care in the UK: where are we? A qualitative study of health policies and professional perspectives. BMC Health Serv Res 2022; 22:1164. [PMID: 36104750 PMCID: PMC9473455 DOI: 10.1186/s12913-022-08461-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Trauma-informed (TI) approach is a framework for a system change intervention that transforms the organizational culture and practices to address the high prevalence and impact of trauma on patients and healthcare professionals, and prevents re-traumatization in healthcare services. Review of TI approaches in primary and community mental healthcare identified limited evidence for its effectiveness in the UK, however it is endorsed in various policies. This study aimed to investigate the UK-specific context through exploring how TI approaches are represented in health policies, and how they are understood and implemented by policy makers and healthcare professionals.
Methods
A qualitative study comprising of a document analysis of UK health policies followed by semi-structured interviews with key informants with direct experience of developing and implementing TI approaches. We used the Ready Extract Analyse Distil (READ) approach to guide policy document review, and the framework method to analyse data.
Results
We analysed 24 documents and interviewed 11 professionals from healthcare organizations and local authorities. TI approach was included in national, regional and local policies, however, there was no UK- or NHS-wide strategy or legislation, nor funding commitment. Although documents and interviews provided differing interpretations of TI care, they were aligned in describing the integration of TI principles at the system level, contextual tailoring to each organization, and addressing varied challenges within health systems. TI care in the UK has had piecemeal implementation, with a nation-wide strategy and leadership visible in Scotland and Wales and more disjointed implementation in England. Professionals wanted enhanced coordination between organizations and regions. We identified factors affecting implementation of TI approaches at the level of organization (leadership, service user involvement, organizational culture, resource allocation, competing priorities) and wider context (government support, funding). Professionals had conflicting views on the future of TI approaches, however all agreed that government backing is essential for implementing policies into practice.
Conclusions
A coordinated, more centralized strategy and provision for TI healthcare, increased funding for evaluation, and education through professional networks about evidence-based TI health systems can contribute towards evidence-informed policies and implementation of TI approaches in the UK.
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McLindon E, Diemer K, Kuruppu J, Spiteri-Staines A, Hegarty K. "You can't swim well if there is a weight dragging you down": cross-sectional study of intimate partner violence, sexual assault and child abuse prevalence against Australian nurses, midwives and carers. BMC Public Health 2022; 22:1731. [PMID: 36096766 PMCID: PMC9469630 DOI: 10.1186/s12889-022-14045-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background Domestic and family violence (DFV), including intimate partner violence (IPV), sexual assault and child abuse are prevalent health and social issues, often precipitating contact with health services. Nurses, midwives and carers are frontline responders to women and children who have experienced violence, with some research suggesting that health professionals themselves may report a higher incidence of IPV in their personal lives compared to the community. This paper reports the largest study of DFV against health professionals to date. Method An online descriptive, cross-sectional survey of 10,674 women and 772 men members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch). The primary outcome measures were 12-month and adult lifetime IPV prevalence (Composite Abuse Scale); secondary outcomes included sexual assault and child abuse (Australian Bureau of Statistics Personal Safety Survey) and prevalence of IPV perpetration (bespoke). Results Response rate was 15.2% of women/11.2% of men who were sent an invitation email, and 38.4% of women/28.3% of men who opened the email. In the last 12-months, 22.1% of women and 24.0% of men had experienced IPV, while across the adult lifetime, 45.1% of women and 35.0% of men had experienced IPV. These figures are higher than an Australian community sample. Non-partner sexual assault had been experienced by 18.6% of women and 7.1% of men, which was similar to national community sample. IPV survivors were 2-3 times more likely to have experienced physical, sexual or emotional abuse in childhood compared to those without a history of IPV (women OR 2.7, 95% CI 2.4 to 2.9; men OR 2.8, 95% CI 2.0 to 4.1). Since the age of sixteen, 11.7% of men and 1.7% of women had behaved in a way that had made a partner or ex-partner feel afraid of them. Conclusions The high prevalence of intimate partner violence and child abuse in this group of nurses, midwives and carers suggests the need for workplace support programs. The findings support the theory that childhood adversity may be related to entering the nursing profession and has implications for the training and support of this group.
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Huang W, Zhang F, Sun X, Yu Q, Huang J, Su Y, Lan Y. Association between intimate partner psychological violence and psychological distress among nurses: The role of personality traits and social support. Front Psychol 2022; 13:1038428. [PMID: 36710775 PMCID: PMC9878691 DOI: 10.3389/fpsyg.2022.1038428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/15/2022] [Indexed: 01/13/2023] Open
Abstract
AIM This study proposes investigating the risk and protective factors of intimate partner (IP) psychological violence and psychological distress to better promote psychological wellbeing for nurses and health outcomes for patients. DESIGN A cross-sectional study. METHOD This cross-sectional study was carried out chiefly in Guangdong, Hunan, and Shaanxi provinces, in the east, central, and west of the Chinese economic areas, respectively. It was conducted in October 2021 using convenience sampling. A total of 843 nurses were eligible for the final analysis. Single-factor linear regression models were used to identify potential factors associated with IP psychological violence and psychological distress. In addition, the structural equation model was used to explore the role of personality traits and social support in the association between IP psychological violence and psychological distress. RESULTS The predictors for the score of IP psychological violence among nurses were participants' married status, contact frequency with a partner, perceived past-year psychological and physical violence experience, the alcohol consumption of partners, and personality traits and social support of partners. Moreover, the alcohol consumption of participants, the past-year experience of IP psychological violence, the score of psychological violence, personality traits, social support, and the personality traits of partners were associated factors affecting the psychological distress of nurses. In the structural model, the personality trait of partners had a direct pathway to psychological violence and social support. The results demonstrated that psychological violence significantly increased psychological distress. CONCLUSION Personality traits and social support are essential factors influencing the relationship between IP psychological violence and psychological distress. IMPACT The findings of this study emphasize the possibility and importance of identification and intervention for reducing IP psychological violence based on personality traits and social support.
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Affiliation(s)
- Wentao Huang
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
- Department of Nursing, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
- *Correspondence: Wentao Huang ✉
| | - Fan Zhang
- Department of Emergency Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Xibin Sun
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Qing Yu
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
- Department of Emergency Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Jingxin Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
- Department of Emergency Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Yunhui Su
- Department of Emergency Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Yunhui Su ✉
| | - Yutao Lan
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
- Yutao Lan ✉
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