Improving the response of primary care providers to rural First Nation women who experience intimate partner violence: a qualitative study

Prevalence and risk factors for intimate partner violence and indigenous women: A scoping review

AIM

This study aims to map intimate partner violence evidence among indigenous women and explore the prevalence, social and systemic factors contributing to this occurrence.

METHODS

This is a scoping review following the steps recommended by the JBI. We searched the MEDLINE/PubMed®, Web of Science™, Embase, CINAHL and LILACS databases on March 2023. Studies that addressed the intimate partner violence topic among indigenous women and risk factors, without time and language limitations, were included. Detailed information was extracted, standardized by JBI.

RESULTS

Twenty studies of different designs were included, all published in English, between 2004 and 2022. A high intimate partner violence prevalence among indigenous women was identified, associated with a great diversity of risk factors.

CONCLUSION

The great diversity of identified factors associated with its occurrence shows the complexity of this problem and the vulnerability of indigenous women.

"You Can't Meet Everyone's Needs After-Hours": After-Hours Domestic and Family Violence Services in Rural and Remote Areas

Domestic and family violence is a significant issue in the Murrumbidgee region of New South Wales, Australia, mirroring national and international concerns about gender-based violence. Generally, there are known barriers associated with providing domestic and family violence (DFV) services in rural and remote communities; however, little research has considered the specific service needs and service barriers in the after-hours period. This is crucial. The already limited rural and remote services available during business hours are further constricted in the after-hours period. This article reports on research about after-hours service need and service challenges in six target communities in the Murrumbidgee region.

The impact of the war in Ukraine on the perinatal period: Perinatal mental health for refugee women (pmh-rw) protocol

Background

The aim of the Perinatal Mental Health for Refugee Women (PMH-RW) Project is to investigate the impact of the war on perinatal mental health: anxiety, post-traumatic stress, depression, and birth trauma symptoms. It will also evaluate the factors that serve as protective elements for the development of these potential diagnoses (such as personality traits, social support, sociodemographic characteristics, and access to medical/mental health services).

Method

An international observational cohort study with baseline data is being assessed in Ukraine (for internal refugees) and several European Countries (for external refugees). The study includes as participants both pregnant women and those who have recently given birth (with babies up to 1 year old). The assessment includes measures on depression (EPDS), anxiety (GAD-7), experiences during birth (City Birth Questionnaire), post-traumatic stress symptoms [Impact of events scale—revised (PTSD-R)], Personality (10-Item Personality Inventory-TIPI), and a questionnaire for socio-demographic data which also such social support.

Conclusion

This study will provide needed information for determining the impact of the Ukrainian Crisis on perinatal mental health by studying potential risk and protective factors. The data collected will be used to inform policymakers with useful information that can be used in the development of plans to protect and promote the mental health of the perinatal refugees impacted by this event. Also, it is our hope that data collected from this study will serve to plant the seeds for further research regarding the impact of the crisis in Ukraine on the offspring and to analyze how these events are affecting further generations.

Clinical Trial Registration

ClinicalTrials.gov, Identifier: NCT05654987.

A scoping review of the healthcare provided by nurses to people experiencing domestic violence in primary health care settings

Background

Domestic and family violence is a significant and growing public health concern in many communities around the world. Nurses are often the first and sometimes only point of contact for people seeking healthcare following DFV incidents and are therefore well placed to identify and support these vulnerable people. The aim of this scoping review is to examine the English language studies of healthcare provided by nurses in primary healthcare settings to people experiencing domestic and family violence.

Methods

A scoping review of the following databases was undertaken between March-June 2021: CINAHL, Medline, and PubMed. Primary studies were included if written in English, published from 2000 onwards, and focused on the care provided by primary healthcare nurses to people experiencing DFV. A critical appraisal of included studies was conducted using the Mixed Methods Appraisal Tool (MMAT). Results were synthesised narratively.

Results

Six studies were included, from the United States (n = 2), United Kingdom (n = 1), Sweden (n = 2), and Brazil (n = 1). Five studies were quantitative and one qualitative. A fundamental aspect of the healthcare provided by nurses, reported by all studies, was the screening of DFV. Other healthcare provided includes physical and mental health assessment and referral to other services, including sexual assault clinics, social supports, and law enforcement agencies. Findings suggest the level of DFV screening conducted by nurses is limited. Nurses' knowledge of how to support people experiencing DFV was also reportedly limited. Two studies reported that nurses were unfamiliar with DFV practice guidelines and the existence and availability of support networks for people experiencing DFV.

Conclusion

Findings suggest inconsistency in primary healthcare nurses' level of education, skill and knowledge, and detection of people experiencing DFV. As the largest healthcare professional discipline, nurses have frequent contact with people experiencing DFV. There is an urgent need for nurses to be better educationally prepared and more organisationally supported in order to adequately respond and provide healthcare to people experiencing DFV. Given that the number of people experiencing DFV has increased due to the COVID-19 pandemic, it is ever more important for nurses to be well equipped to identify and respond appropriately.

Navigating Paths to Wellness: A Strengths-Based Photovoice Study Conducted with One First Nation in Southern Ontario, Canada

Research on substance use challenges in First Nations communities is often deficit-focused and can reinforce paternalistic stereotypes that lead to further discrimination. In this article, we report on findings of a strengths-based Photovoice project done in collaboration with a First Nations' community in southern Ontario, Canada to better understand experiences with substance use challenges in the community. We analyzed interview data collected with seventeen individuals who have lived experience or are supporting a loved one with lived experience with a substance use challenge. Participants described sources of strength that characterized their path to wellness, including strong family and social connections, cultural practices, identity, spirituality, day-to-day activities, and helpful supports and services. Furthermore, participants made several suggestions for improving services, including the need for integrated and flexible systems of care and trustful client-provider relationships. At its core, nurturing wellness involved a transformative process involving social and/or cultural connections. The stories shared by participants demonstrate the unique and varied strengths drawn from by individuals dealing with a substance use challenge.

Concept analysis of shame in nursing

Nurses can facilitate opportunities for patients who feel shame to experience healing in their mental health. Disciplines such as psychology have extensive shame research, yet nursing may provide a unique perspective to bolster research on shame. The objective of this analysis is to examine the use of shame as a concept in nursing literature. This review was guided by Beth Rodgers' Evolutionary approach to concept analysis. Rodgers' approach entails investigating attributes, related terms, surrogate terms, antecedents, and consequences of shame; and examining the use of the concept shame over time to determine if its use changed. Sampled literature came from Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, PubMed, Web of Science, and Health Source: Nursing/Academic Edition. The final sample used for analysis included 334 sources published between 1993 and 2020. The use of shame did not change during these years. Attributes were negative sense of self, feeling worthless, and feeling vulnerable. There were no surrogate terms and three related terms: guilt, humiliation, and embarrassment. Antecedents were trauma, stigma, and perception of moral wrongdoing. Consequences included healthcare avoidance, social withdrawal or isolation, negative coping mechanisms, resilience, lifestyle changes, and healthy coping. There is a discrepancy between the conceptualization and use of shame in nursing and other disciplines. Other disciplines, such as psychology, provide more direction about how interpersonal interactions can elicit or alleviate feelings of shame. Nurses can apply this conceptualization in their clinical practice to support patients experiencing shame.