The effect of solution-focused counseling on violence rate and quality of life of pregnant women at risk of domestic violence: a randomized controlled trial

Interventions for intimate partner violence during the perinatal period: A scoping review: A systematic review

Background

Intimate partner violence (IPV) is a prevalent global health problem. IPV that occurs before pregnancy often continues during the perinatal period, resulting in ongoing violence and many adverse maternal, obstetrical, and neonatal outcomes.

Objectives

This scoping review is designed to broadly capture all potential interventions for perinatal IPV and describe their core components and measured outcomes.

Search Methods

We conducted a search for empirical studies describing IPV interventions in the perinatal population in June 2022. The search was conducted in MEDLINE, EMBASE, PsycInfo, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, Applied Social Sciences Index & Abstracts, ClinicalTrials.gov and MedRxiv. Hand searching of references from select articles was also performed.

Selection Criteria

Included studies described an intervention for those experiencing IPV during the perinatal period, including 12 months before pregnancy, while pregnant or in the 12 months post-partum. The search encompassed January 2000 to June 2022 and only peer-reviewed studies written in either English or French were included. Included interventions focused on the survivor exposed to IPV, rather than healthcare professionals administering the intervention. Interventions designed to reduce IPV revictimization or any adverse maternal, obstetrical, or neonatal health outcomes as well as social outcomes related to IPV victimization were included.

Data Collections and Analysis

We used standard methodological procedures expected by The Campbell Collaboration.

Main Results

In total, 10,079 titles and abstracts were screened and 226 proceeded to full text screening. A total of 67 studies included perinatal IPV interventions and were included in the final sample. These studies included a total of 27,327 participants. Included studies originated from 19 countries, and the majority were randomized controlled trials (n = 43). Most studies were of moderate or low quality. Interventions included home visitation, educational modules, counseling, and cash transfer programs and occurred primarily in community obstetrician and gynecologist clinics, hospitals, or in participants' homes. Most interventions focused on reducing revictimization of IPV (n = 38), improving survivor knowledge or acceptance of violence, knowledge of community resources, and actions to reduce violence (n = 28), and improving maternal mental health outcomes (n = 26). Few studies evaluated the effect of perinatal IPV interventions on obstetrical, neonatal or child health outcomes.

Authors' Conclusions

The majority of intervention studies for perinatal IPV focus on reducing revictimization and improving mental health outcomes, very few included obstetrical, neonatal, and other physical health outcomes. Future interventions should place a larger emphasis on targeting maternal and neonatal outcomes to have the largest possible impact on the lives and families of IPV survivors and their infants.

The effect of a behavioural intervention package on quality of life of pregnant women experiencing domestic violence: a randomised controlled trial

BACKGROUND

Domestic violence during pregnancy is especially concerning due to its significant detrimental impact on a woman's health and that of her unborn child. The study aims to evaluate the effects of a behavioural intervention package (BIP) delivered during pregnancy on the quality of life (QOL), domestic violence (DV), and reproductive and child health (RCH) of women experiencing DV.

METHODS

A randomised controlled trial was conducted on 211 pregnant women recruited between 18 and 20 weeks of pregnancy and randomly assigned to one of two groups: intervention (n = 105) or control (n = 106). The intervention group received BIP and standard care, while the control group received only standard care for 28 weeks. Study tools included socio-demographic variables, a short-form health survey, an abuse assessment screening tool, and an RCH checklist. The tools were completed once before the intervention and again at 6 weeks postnatal. The tools and their subscales were compared pre- and post-intervention using a paired t-test, or Wilcoxon signed test as appropriate to estimate the effect size at baseline and post-intervention.

RESULTS

Post-intervention, the QOL scores were found to be significant, with a positive effect favouring the intervention as compared to the control group. The BIP intervention, which was found to be significantly effective (P ≤ 0.001) in reducing DV for pregnant women experiencing DV, was higher in the intervention group than in the control group.

CONCLUSION

The BIP may be an appropriate method for treating pregnant women experiencing DV from low socioeconomic strata who attend public hospitals in India to improve their QOL. The approach may offer an intervention that healthcare institutions or other organizations in contact with women at risk of violence can implement.

TRIAL REGISTRATION

Indian Registry of Clinical Trials CTRI/2019/01/017009. Registered on 09/01/2019.

The Effectiveness and Feasibility of Psychological Interventions for Populations Under Ongoing Threat: A Systematic Review

Current views of psychological therapies for trauma typically assume the traumatic event to be in the past. Yet, individuals who live in contexts of ongoing organized violence or experience intimate partner violence (IPV) may continue to be (re)exposed to related traumatic events or have realistic fears of their recurrence. This systematic review considers the effectiveness, feasibility, and adaptations of psychological interventions for individuals living with ongoing threat. PsychINFO, MEDLINE, and EMBASE were searched for articles that examined psychological interventions in contexts of ongoing threat of either IPV or organized violence and used trauma-related outcome measures. The search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on study population, ongoing threat setting and design, intervention components, evaluation methods, and outcomes were extracted, and study quality was assessed using the Mixed-Method Appraisal Tool. Eighteen papers featuring 15 trials were included (12 on organized violence and 3 on IPV). For organized violence, most studies showed moderate to large effects in reducing trauma-related symptoms when compared to waitlists. For IPV, findings were varied. Most studies made adaptations related to culture and ongoing threat and found that providing psychological interventions was feasible. The findings, albeit preliminary with mixed methodological quality, showed psychological treatments can be beneficial and should not be withheld in the context of ongoing organized violence and IPV. Clinical and research recommendations are discussed.

Interventions Focused by Nurses for Reducing Negative Effect of Traumatic Experience on Victims of Sexual Violence: A Scoping Review

Sexual violence has increased quite rapidly. Sexual violence can be in the form of physical or verbal violence. The impact of sexual violence causes a traumatic experience that causes physical problems, psychological problems, loss of the future, and causes the risk of death. Nurses have an important role in reducing the impact of sexual violence on victims. The purpose of this study is to describe nursing interventions to reduce the impact of traumatic experiences experienced by victims of sexual violence. This study used a scoping review method. The literature used in this study is from CINAHL, PubMed, and Scopus. Keywords in this study are sexual violence, traumatic experience, impact, and victims. Search strategy used PRISMA Extension for Scoping Reviews to select articles for this study. The inclusion criteria were that the sample was female victims of sexual violence, studies employed a randomized control trial or quasi-experimental research design, and the publication period was of the last 10 years (2013-2022). We found 10 articles that matched the inclusion and exclusion criteria. The findings from this scoping review show that nursing interventions can reduce the impact of traumatic experiences on victims of sexual violence. There are three methods of nursing intervention, namely cognitive behavior, counseling, and web-based intervention. The samples are from developing and developed countries. The range of the samples are from 35-1250 respondents. Nursing interventions focus on victims in order to improve mental health and reduce the traumatic impact experienced by victims of sexual violence. The activities carried out were psychoeducation, keeping a daily journal, and discussions related to the traumatic experiences experienced. Nurses as health workers have a role to provide comprehensive nursing care to victims of sexual violence by taking into account the characteristics and impact of trauma experienced by victims of sexual violence.

‘It is a hard decision’: a qualitative study of perinatal intimate partner violence disclosure

Background

Perinatal intimate partner violence is a hidden under reported and difficult to identify problem which has negative effects on mother and child. The present study aimed to explore barriers and facilitators of perinatal intimate partner violence disclosure.

Methods

This qualitative study was carried out from October 2019 to January 2021 in Mashhad, Iran. Participants included 23 abused women (11 pregnant and 12 after birth) which were selected via purposive sampling. Semi-structured in-depth interviews and focus group discussion were conducted until the data saturation was achieved. The data analysis was performed based on conventional content analysis adopted by Graneheim & Lundman.

Results

The main themes “barriers to disclosure” and “facilitators of disclosure” were emerged as the result of data analysis. Barriers to disclosure included negative disclosure consequences and protection of family privacy. Facilitators of disclosure included maternal self-efficacy, threats to security, and formal and informal supportive networks.

Conclusions

Most abused women did not disclose violence despite routine screening for perinatal intimate partner violence in antenatal care. Recognizing the barriers to and facilitators of violence disclosure play an important role in eliminating barriers, strengthening facilitators, providing effective supportive services for abused women, and reducing perinatal violence. Focus on the barriers to and the facilitators of disclosure will be useful to policymakers, health program planners, and health care providers to identify and manage intimate partner violence, appropriately.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12978-022-01514-7.

Disclosure of perinatal intimate partner violence is a difficult decision. Several barriers prevent abused pregnant women from disclosing violence. The present study explained barriers and facilitators of perinatal intimate partner violence disclosure. 23 women (11 pregnant and 12 after birth) who experienced perinatal intimate partner violence were interviewed in Mashhad, Iran. The results showed the barriers to disclosure include negative disclosure consequences and protection of family privacy and the facilitators of disclosure include maternal self-efficacy, threats to security, and formal and informal supportive networks. In conclusion eliminating barriers and strengthen facilitators play an important role in providing effective supportive services for abused women and reducing perinatal violence. The result will be useful to policymakers, health program planners, and health care providers for appropriate management of perinatal intimate partner violence.

Quality of Life During Pregnancy from 2011 to 2021: Systematic Review

Purpose

Health-related quality of life (HRQoL) has emerged as a key concern in patient care. It has become one of the major objectives of clinical trials. Our study aims to describe the quality of life (QoL) during uncomplicated pregnancy and to assess its associated factors.

Patients and Methods

The search of articles was carried out using the online database of PUBMED and Web of Science with a limit of time between 2011 and 2021. Data were retrieved by two independent reviewers.

Results

721 publications responding to keywords were identified, of which 73 articles on the topic were selected. The main countries that have published on this subject are Australia (n = 10) and China (n = 7). Twenty-three articles deal with QoL for pathological pregnancies. All the pathologies studied have a negative impact on the HRQoL of pregnant women, and its improvement depends on the type of treatment. Obesity, low back, and pelvic girdle pain, and hyperemesis gravidarum were the frequent pathologies during pregnancy. Socio-demographic characteristics related to improved well-being (favorable economic status, social support). Similarly, better sleep quality and moderate physical exercise were linked to an increased QoL. Physical and psychological factors were associated with a lower QoL.

Conclusion

The HRQoL refers to patients’ subjective evaluation of physical, mental, and social components of well-being. Optimizing the QoL during pregnancy necessitates a deeper understanding of their issues as well as counseling which provides support wherever needed.

Family focused interventions that address parental domestic violence and abuse, mental ill-health, and substance misuse in combination: A systematic review

Parental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) are three public health issues that tend to cluster within families, risking negative impacts for both parents and children. Despite this, service provision for these issues has been historically siloed, increasing the barriers families face to accessing support. Our review aimed to identify family focused interventions that have combined impacts on parental DVA, MH, and/or SU. We searched 10 databases (MEDLINE, PsycINFO, Embase, CINAHL, Education Research Information Centre, Sociological Abstracts, Applied Social Sciences Index & Abstracts, ProQuest Dissertations and Theses Global, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials) from inception to July 2021 for randomised controlled trials examining the effectiveness of family focused, psychosocial, preventive interventions targeting parents/carers at risk of, or experiencing, DVA, MH, and/or SU. Studies were included if they measured impacts on two or more of these issues. The Cochrane Risk of Bias Tool 2 was used to quality appraise studies, which were synthesised narratively, grouped in relation to the combination of DVA, MH, and/or SU outcomes measured. Harvest plots were used to illustrate the findings. Thirty-seven unique studies were identified for inclusion. Of these, none had a combined positive impact on all three outcomes and only one study demonstrated a combined positive impact on two outcomes. We also found studies that had combined adverse, mixed, or singular impacts. Most studies were based in the U.S., targeted mothers, and were rated as 'some concerns' or 'high risk' of bias. The results highlight the distinct lack of evidence for, and no 'best bet', family focused interventions targeting these often-clustered risks. This may, in part, be due to the ways interventions are currently conceptualised or designed to influence the relationships between DVA, MH, and/or SU. Trial registration: PROSPERO registration: CRD42020210350.

Women's strategies for managing domestic violence during pregnancy: a qualitative study in Iran

BACKGROUND

Domestic violence during pregnancy is a severe public health problem. Abused pregnant women are confronted with the threats posed by domestic violence. Pregnancy and protection of the unborn child could affect maternal strategies for managing violence. The purpose of this study was to explore Iranian women's strategies for managing domestic violence during pregnancy.

METHODS

This qualitative study was conducted in October 2019 to June 2021 in Mashhad, Iran. Data were collected through individual semi structured interviews with 13 women who experienced perinatal domestic violence, two relatives and 24 related specialists as well as two focus group discussions with attendance of 20 abused mothers until the data saturation was achieved. Data were analyzed by the conventional content analysis approach of Graneheim and Lundman.

RESULTS

The main themes "escape strategies" and "situation improvement strategies" were emerged as the result of data analysis. Escape strategies was comprised of three categories including concealment, passive dysfunctional behaviors and neutral behaviors to control maternal emotional distress. Situation improvement strategies was comprised of three categories including active self-regulation, protecting family privacy and help seeking to control violence.

CONCLUSION

Understanding the experience of managing domestic violence among pregnant women is essential to design evidence based violence prevention programs, which enable supportive healthcare and social systems to encourage abused mothers to use more effective strategies and seeking help to overcome domestic violence.

Clinical Study on Effect of Solution Focused Approach on the Complications, Pain, Sleep, and Quality of Life in Patients with Hepatocellular Carcinoma Undergoing TACE

Objective

The objective of this study is to explore the effect of solution focused approach (SFA) on the complications, pain, sleep, and quality of life in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization (TACE).

Methods

Total of 106 patients with hepatocellular carcinoma who underwent TACE in our hospital from July 2019 to June 2020 were selected. According to the admission time, they were divided into the control group (n = 53) and the observation group (n = 53). The control group implemented routine nursing intervention, and the observation group implemented SFA on the basis of the control group. The clinical data, complications, pain, sleep status, and quality of life scores were compared between the two groups.

Results

The total incidence of complications in the observation group (16.98%) was lower than that in the control group (33.96%) (P < 0.05). There was no significant difference in the score of pain perception between the two groups (P > 0.05). The scores of sleep status in the observation group were lower than those in the control group (P < 0.05). The quality of life scores in the observation group was higher than that in the control group (P < 0.05).

Conclusion

SFA can effectively reduce the complications, relieve pain, improve sleep status, and improve the quality of life in patients with hepatocellular carcinoma undergoing TACE.