1
|
Sarica Çevik H, Tekiner S, Ceyhun Peker AG, Ungan M. Attitudes and behaviours of family physicians towards clinical practice around intimate partner violence: a view from the Çankaya district of Ankara, Turkey. Aust J Prim Health 2023; 29:625-636. [PMID: 37345261 DOI: 10.1071/py22133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/19/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Although family physicians (FPs) often encounter patients who have been subjected to intimate partner violence (IPV), the data on FPs' response to IPV is limited. This study aimed to determine FPs' attitudes towards IPV survivors in the Çankaya district of Ankara, Turkey. METHODS An online questionnaire designed to elicit sociodemographic information and FPs' attitudes towards IPV was distributed between 20 August 2021 and 20 October 2021. RESULTS Eighty-nine FPs participated in the study. Of the participants, 71.9% had a patient diagnosed with IPV during their practice. Of these physicians, 100% diagnosed physical, 56.3% sexual, 71.9% psychological, 53.1% economic, and 10.9% cyber violence. Among these physicians, sexual, psychological, and economic violence were determined at higher rates by family medicine specialists (FMSs) compared to general practitioners (GPs), by FPs who had received IPV training compared to those who were untrained, and by female physicians compared to males (P <0.05). Despite diagnosing IPV, some physicians did not intervene/guide their patients, and some only consoled their patients because they thought the situation was inevitable. The reasons for not taking official action included insufficient time, feeling uncomfortable talking about violence, lack of information about the detection and reporting, and the thought that the woman would not leave her abusive partner. CONCLUSIONS The results showed that among the physicians who encountered IPV, female sex, family medicine speciality training, and IPV training resulted in acting more consciously in diagnosing violence, implementing referral and notification systems, and approaching IPV survivors. The prevention of IPV could be made possible by supporting FPs with ongoing training, breaking down stereotypes and prejudices about gender roles, and changing the structures that maintain unequal power relationships.
Collapse
Affiliation(s)
| | - Selda Tekiner
- Department of Family Medicine, Ankara University Medical School, Altindag, Ankara 06230, Turkey
| | | | - Mehmet Ungan
- Department of Family Medicine, Ankara University Medical School, Altindag, Ankara 06230, Turkey
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Vonkeman J, Atkinson P, Fraser J, McCloskey R, Boyle A. Intimate Partner Violence Documentation and Awareness in an Urban Emergency Department. Cureus 2019; 11:e6493. [PMID: 32025415 PMCID: PMC6984185 DOI: 10.7759/cureus.6493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Domestic violence rates in smaller cities have been reported to be some of the highest in Canada. It is highly likely that the staff at emergency departments (ED) will come in contact with victims of intimate partner violence in their daily practice. The purpose of this study is to better understand current practices for detecting intimate partner violence, staff awareness and knowledge regarding intimate partner violence, and barriers to questioning about intimate partner violence in the ED. Methods A standardized retrospective chart review captured domestic violence documentation rates in patients presenting to the ED, and a cross-sectional online survey was distributed to the ED staff. Results We found documentation about intimate partner violence in 4.64% of all included patient charts. No documentation was noted in the domestic violence field. Significantly, 16.4% of the ED staff reported never questioning female patients about intimate partner violence; 83.6% enquired when they thought it appropriate, and none asked routinely. None of the staff used a structured screening tool, and 81.8% of the ED staff had not received any formal training. Partner presence was the most common barrier to asking about intimate partner violence, followed by a lack of access to domestic violence management information, and a lack of knowledge regarding intimate partner violence. Conclusions Our findings suggest that the current documentation tools are not being properly utilized. Low rates of intimate partner violence documentation in high-risk patients and lack of education indicate that there is a need to improve current practices. In order to improve identification of this important problem, appropriate training and education about intimate partner/domestic violence are required to increase staff comfort as well as knowledge about available community resources for the victims.
Collapse
Affiliation(s)
| | - Paul Atkinson
- Emergency Medicine, Saint John Regional Hospital, Saint John, CAN
| | | | - Rose McCloskey
- Emergency Medicine, University of New Brunswick, Saint John, CAN
| | - Adrian Boyle
- Emergency Medicine, Addenbrookes Hospital Cambridge University, Cambridge, GBR
| |
Collapse
|
4
|
Guček NK, Selič P. Depression in Intimate Partner Violence Victims in Slovenia: A Crippling Pattern of Factors Identified in Family Practice Attendees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020210. [PMID: 29373551 PMCID: PMC5858279 DOI: 10.3390/ijerph15020210] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 11/16/2022]
Abstract
This multi-centre cross-sectional study explored associations between prevalence of depression and exposure to intimate partner violence (IPV) at any time in patients' adult life in 471 participants of a previous IPV study. In 2016, 174 interviews were performed, using the Short Form Domestic Violence Exposure Questionnaire, the Zung Scale and questions about behavioural patterns of exposure to IPV. Family doctors reviewed patients' medical charts for period from 2012 to 2016, using the Domestic Violence Exposure Medical Chart Check List, for conditions which persisted for at least three years. Depression was found to be associated with any exposure to IPV in adult life and was more likely to affect women. In multivariable logistic regression modelling, factors associated with self-rated depression were identified (p < 0.05). Exposure to emotional and physical violence was identified as a risk factor in the first model, explaining 23% of the variance. The second model explained 66% of the variance; past divorce, dysfunctional family relationships and a history of incapacity to work increased the likelihood of depression in patients. Family doctors should consider IPV exposure when detecting depression, since lifetime IPV exposure was found to be 40.4% and 36.9% of depressed revealed it.
Collapse
Affiliation(s)
- Nena Kopčavar Guček
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia.
| | - Polona Selič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia.
| |
Collapse
|
5
|
Leskošek V, Lučovnik M, Pavše L, Sršen TP, Krajnc M, Verdenik I, Velikonja VG. The Role of Health Services in Encouraging Disclosure of Violence Against Women. Zdr Varst 2017; 56:220-226. [PMID: 29062396 PMCID: PMC5639811 DOI: 10.1515/sjph-2017-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 07/06/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction The aim of the survey was to assess the differences in disclosure by the type of violence to better plan the role of health services in identifying and disclosing violence. Methods A validated, anonymous screening questionnaire (NorAQ) for the identification of female victims of violence was offered to all postpartum women at a single maternity unit over a three-month period in 2014. Response rate was 80% (1018 respondents). Chi square test was used for statistical analysis (p<0.05 significant). Results There are differences in disclosure by type of violence. Nearly half (41.5%) of violence by health care services was not reported, compared to 33.7% physical, 23.4% psychological, and 32.5% sexual that was reported. The percentage of violence in intimate partnership reported to health care staff is low (9.3% to 20.8%), but almost half of the violence experienced by heath care services (44%) is reported. Intimate partnership violence is more often reported to the physician than to the psychologist or social worker. Violence in health care service is reported also to nurses. Conclusions Disclosure enables various institutions to start with the procedures aimed at protecting victims against violence. Health workers should continuously encourage women to speak about violence rather than asking about it only once. It is also important that such inquiries are made on different levels of health care system and by different health care professions, since there are differences to whom women are willing to disclose violence.
Collapse
Affiliation(s)
- Vesna Leskošek
- University of Ljubljana, Faculty of Social Work, Topniška 31, 1000, Ljubljana, Slovenia
| | - Miha Lučovnik
- University Medical Centre Ljubljana, Division of Obstetrics and Gynaecology, Department of Perinatology, Šlajmerjeva 3, 1000, Ljubljana, Slovenia
| | - Lucija Pavše
- University Medical Centre Ljubljana, Division of Obstetrics and Gynaecology, Department of Perinatology, Šlajmerjeva 3, 1000, Ljubljana, Slovenia
| | - Tanja Premru Sršen
- University Medical Centre Ljubljana, Division of Obstetrics and Gynaecology, Department of Perinatology, Šlajmerjeva 3, 1000, Ljubljana, Slovenia
| | - Megie Krajnc
- University Medical Centre Ljubljana, Division of Obstetrics and Gynaecology, Department of Perinatology, Šlajmerjeva 3, 1000, Ljubljana, Slovenia
| | - Ivan Verdenik
- University Medical Centre Ljubljana, Division of Obstetrics and Gynaecology, Department of Perinatology, Šlajmerjeva 3, 1000, Ljubljana, Slovenia
| | - Vislava Globevnik Velikonja
- University Medical Centre Ljubljana, Division of Obstetrics and Gynaecology, Department of Perinatology, Šlajmerjeva 3, 1000, Ljubljana, Slovenia
| |
Collapse
|
6
|
Zorjan S, Smrke U, Šprah L. The Role of Attitudes to, and the Frequency of, Domestic Violence Encounters in the Healthcare Professionals' Handling of Domestic Violence Cases. Zdr Varst 2017; 56:166-171. [PMID: 28713445 PMCID: PMC5504542 DOI: 10.1515/sjph-2017-0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 03/20/2017] [Indexed: 11/30/2022] Open
Abstract
Background Domestic violence is recognized as a public health problem with a high prevalence in the general population. Healthcare professionals play an important role in the recognition and treatment of domestic violence. Hence, conducting research on factors that facilitate or inhibit appropriate actions by healthcare professionals is of the upmost importance. The objective of the study was to examine the relationship between healthcare professionals’ attitudes toward the acceptability of domestic violence and their responses when dealing with victims of domestic violence. Methods The sample consisted of 322 healthcare professionals (physicians, dentists, nursing staff and other healthcare workers; 85.2% female), who completed a questionnaire, assessing their attitudes towards domestic violence, experience, behaviour and perceived barriers in recognizing and treating domestic violence in the health care sector. The study was cross-sectional and used availability sampling. Results The results showed no significant differences in domestic violence acceptability attitudes when comparing groups of healthcare professionals who reported low or high frequency of domestic violence cases encounters. Furthermore, we found that domestic violence acceptability attitudes were negatively associated with action taking when the frequency of encounters with domestic violence cases was high and medium. However, the attitudes were not associated with action taking when the frequency of encounters with domestic violence cases was low. Conclusions The results highlight the important role of attitudes in action taking of healthcare professionals when it comes to domestic violence. This indicates the need for educational interventions that specifically target healthcare professionals’ attitudes towards domestic violence.
Collapse
Affiliation(s)
- Saša Zorjan
- Research Centre of the Slovenian Academy of Sciences and Arts, Sociomedical Institute, Novi trg 2, 1000Ljubljana, Slovenia
- Tel: ++ 386 41 855 010; E-mail:
| | - Urška Smrke
- Research Centre of the Slovenian Academy of Sciences and Arts, Sociomedical Institute, Novi trg 2, 1000Ljubljana, Slovenia
| | - Lilijana Šprah
- Research Centre of the Slovenian Academy of Sciences and Arts, Sociomedical Institute, Novi trg 2, 1000Ljubljana, Slovenia
| |
Collapse
|
7
|
Djomba JK, Zaletel-Kragelj L. A methodological approach to the analysis of egocentric social networks in public health research: a practical example. Zdr Varst 2016; 55:256-263. [PMID: 27703548 PMCID: PMC5030837 DOI: 10.1515/sjph-2016-0035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/01/2016] [Indexed: 12/02/2022] Open
Abstract
Introduction Research on social networks in public health focuses on how social structures and relationships influence health and health-related behaviour. While the sociocentric approach is used to study complete social networks, the egocentric approach is gaining popularity because of its focus on individuals, groups and communities. Methods One of the participants of the healthy lifestyle health education workshop ‘I’m moving’, included in the study of social support for exercise was randomly selected. The participant was denoted as the ego and members of her/his social network as the alteri. Data were collected by personal interviews using a self-made questionnaire. Numerical methods and computer programmes for the analysis of social networks were used for the demonstration of analysis. Results The size, composition and structure of the egocentric social network were obtained by a numerical analysis. The analysis of composition included homophily and homogeneity. Moreover, the analysis of the structure included the degree of the egocentric network, the strength of the ego-alter ties and the average strength of ties. Visualisation of the network was performed by three freely available computer programmes, namely: Egonet.QF, E-net and Pajek. The computer programmes were described and compared by their usefulness. Conclusion Both numerical analysis and visualisation have their benefits. The decision what approach to use is depending on the purpose of the social network analysis. While the numerical analysis can be used in large-scale population-based studies, visualisation of personal networks can help health professionals at creating, performing and evaluation of preventive programmes, especially if focused on behaviour change.
Collapse
Affiliation(s)
- Janet Klara Djomba
- University of Ljubljana, Faculty of Medicine, Public Health Centre, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Lijana Zaletel-Kragelj
- University of Ljubljana, Faculty of Medicine, Public Health Centre, Zaloška 4, 1000 Ljubljana, Slovenia
| |
Collapse
|